Friday, April 13, 2007

But that's what is happening.

Without physicians' consent, private companies make millions of dollars buying and selling information about which drugs doctors prescribe for their patients. What many patients and doctors think is confidential information protected by law, is actually for sale to pharmaceutical companies. Those companies then use it to influence prescribing choices made by physicians through aggressive direct marketing.

A bill before Maine's Legislature will halt this invasive and highly lucrative process known as "data mining" while preserving use of the information to track safety, carry out public health studies, monitor Medicaid spending and other public purposes.

LD 838, An Act Protecting the Confidentiality of Prescription Information, will ensure the highest levels of privacy and care by forbidding the sale of doctors' prescribing information to private companies for use in pharmaceutical marketing.

The pharmaceutical industry pays tens of millions of dollars purchasing data culled for them by private companies from drug plans and pharmacy records. Combined with physician lists purchased from the American Medical Association, the industry creates profiles of doctors, including who they are, where they work and what they prescribe. Healthcare privacy experts have described this as a fundamental violation of privacy.

Using sensitive and personal material, drug companies send thousands of pharmaceutical marketing representatives to doctors' offices with the goal of boosting sales. Armed with the physician's prescribing history, the pharmaceutical representative "micro-markets" the doctor by creating a unique sales plan tailored to promote his or her company's drugs over equally effective generics or competing brand name drugs. After a marketing campaign that typically uses "educational" materials, gifts, flattery and free samples, pharmaceutical companies then monitor the doctor's use of their products through more data mining.

The result: patients may be prescribed medicines that are either less effective or more expensive because of propaganda peddled by drug companies.

The stakes are high. According to Stanford researchers, pharmaceutical companies spend about $12 billion each year marketing directly to physicians. In fact, just one more prescription per week from each doctor means an additional $52 million in annual sales for the drug companies. The AMA's income from selling its Physician Masterfile list was $44 million in 2005. A leading prescription data provider had revenues of almost $2 billion last year.

The drug industry, the private health data companies and others profiting from data mining have huge budgets to oppose this legislation. They falsely claim it will prevent the use of prescribing data for education, research and to notify doctors of safety concerns. But LD 838 explicitly allows collection of data for these purposes, and there are existing non-commercial systems to address these needs.

Most doctors disapprove of data mining. Many are outraged when they learn that pharmaceutical companies have been looking over their shoulder. Doctors are starting to fight back and organizations such as the National Physicians Alliance and The Prescription Project are working for tough reforms to ensure that doctors prescribe medicines based on a patient's best interest -- not that of the drug companies.

Passage of LD 838 will protect privacy and help lower prescription drug costs for patients, employers and taxpayers by making it harder for pharmaceutical companies to convince doctors to write more expensive prescriptions. The bottom line is that protecting privacy and promoting good medical practice based on science, not marketing, would be good for doctors, the state and all of us.

Benjamin Schaefer is Maine chairman of the National Physicians Alliance Prescription Data Task Force and practices at Northeast Cardiology Associates in Bangor. Rob Restuccia is the executive director of The Prescription Project, www.prescriptionproject.org, which seeks to eliminate conflicts of interest created by industry marketing.