Professor Tong Guo explains how mandated transparency didn't reduce pharmaceutical payments to physicians—instead, it taught companies to optimize them.

When the federal government mandated that pharmaceutical companies publicly disclose every payment to physicians—from conference sponsorships to consulting fees—policymakers expected transparency to reduce potential conflicts of interest. Instead, the payments kept flowing, and companies learned to optimize them.

In this episode, Professor Tong Guo, an associate professor of Marketing at Duke University’s Fuqua School of Business, discusses her study of the Sunshine Act—a federal law requiring pharmaceutical and medical device companies to publicly disclose payments to healthcare providers. Published in the Journal of Marketing Research (2021), Guo's research using advanced machine learning methods called causal forests analyzed $100 million in payments between 16 antidiabetic brands and 50,000 physicians. Her findings reveal a nuanced reality: while total payments did not decline significantly, they shifted toward physicians who prescribe more expensive drugs and generate higher ROI for firms.

As Guo explains, most disclosed payments are legal, including sponsorships for events, conference travel, and educational presentations. "Much of these expenditures are considered legal," she notes, "so it's natural that it doesn't come with much pressure to cut it down."

"For firms, the number one rule for them to run their business is always to think about their ROI model," she explains. The transparency regulation gave firms information about which competitors were reaching out to which physicians and when, allowing them to optimize their existing relationships for maximum return. When transparency gives all competitors access to the same information, firms don't retreat—they optimize.

For MBA students and professionals, Guo's findings offer critical lessons extending beyond healthcare. Transparency doesn't always lead to restraint. Understanding who benefits from newly available information—and how—is essential across industries, from healthcare to digital marketing. As Guo points out, similar disclosure regulations now apply across industries —from TikTok influencers required to disclose brand sponsorships to financial services and beyond. "Transparency regulations would not necessarily lead to drastic changes of how people practice their business," she says. Different parties have different capabilities to leverage disclosed information, potentially creating new competitive advantages rather than leveling the playing field.

Duke Fuqua Insights features digestible conversations with our faculty about the most impactful research from their careers, including studies they teach in Fuqua classes. New episodes every other week in season.

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Professor Ali Makhdoumi reveals why your friend's social media activity might be compromising your privacy, even when you share nothing at all

Every time your colleague shares their location data or a friend posts their workout routine, they're inadvertently exposing details about you–even if you've never agreed to share your data. This hidden web of data spillovers means companies can predict your preferences, behaviors, and personal information simply by analyzing the digital footprints of people in your network.

In this episode, Professor Ali Makhdoumi of Duke University's Fuqua School of Business discusses his research on personal data markets, based on his paper "Too Much Data: Prices and Inefficiencies in Data Markets," co-authored with 2024 Nobel Prize winner Daron Acemoglu. He explains that what we think of as personal, private data is actually more like a public good. Platforms can infer your information indirectly through your connections, creating what economists call "data externalities."

Makhdoumi explores why current data markets are so structurally inefficient. When your data can be predicted from others' sharing decisions, you lose bargaining power and companies acquire personal information at depressed prices. This creates market dynamics where users share more data than is socially optimal, often receiving compensation that doesn't reflect the full social costs.

The implications extend beyond individual privacy concerns. Makhdoumi's research shows that under certain conditions, shutting down data markets entirely would improve societal welfare. For business leaders, this challenges conventional thinking about data as a valuable corporate asset and raises questions about sustainable data strategies.

Makhdoumi proposes innovative solutions, including "decorrelation" techniques that could allow beneficial data sharing while protecting privacy. He also outlines policy approaches that could help realign market incentives with social benefits. The research offers a framework for companies thinking more strategically about data acquisition, user trust, and the long-term sustainability of data-driven business models.

Duke Fuqua Insights features digestible conversations with our faculty about the most impactful research from their careers, including studies they teach in Fuqua classes. New episodes every other week in season.

For more from Duke Fuqua, visit us on LinkedIn, Instagram, Facebook, Bluesky, and the Duke Fuqua Insights newsletter.

Ronnie Chatterji, Professor at Duke University's Fuqua School of
Business and Chief Economist at OpenAI, joins Jenny Laurence, MBA '26 to discuss his recent research paper analyzing over a million ChatGPT conversations to uncover patterns in where artificial intelligence is making impacts in our homes, our work, and our lives.

Duke Fuqua Insights features digestible conversations with our faculty about the most impactful research from their careers, including studies they teach in Fuqua classes. New episodes every other week in season.

For more from Duke Fuqua, visit us on LinkedIn, Instagram, Facebook, Bluesky, and the Duke Fuqua Insights newsletter.