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I think part of the US government have questioned whether fines actually change the behaviour of big pharma. I'm sure someone in each big pharma company does the sums on the risk of being fined, how much it will be and when it will happen, before they proceed to do what they do. Apart from the fine itself the companies do not seem to be affected much by it. Fines do not seem to impact their reputation as a whole, and investors/shareholders don't seem to mind.

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