Below is a new trailer for the documentary, Money Talks. The documentary is a companion to the independent feature film, Side Effects, which stars Katherine Heigl, of Grey’s Anatomy fame.
“This 50-minute documentary was created to give an in-depth, academic perspective on the questionable marketing tactics of the pharmaceutical industry, and features the commentary of investigative journalists and medical professionals including Dr. John Abramson, author of Overdosed America, and Prescription Access Litigation Project Director, Alex Sugerman-Brozan. Other notable interviewees include Dr. Bob Goodman of Columbia University, founder of the ‘No Free Lunch’ program, and Dr. Jerome Hoffman of UCLA Medical School.”
An excellent op-ed ran this week in the San Francisco Chronicle, “Prescription mining raises millions for doctors’ group.” It highlights the American Medical Association’s sale of physician profiles and data to drug companies, to help those drug companies convince doctors to prescribe the most expensive brand-name drugs over cheaper and often equally effective older and generic drugs.
As the op-ed points out, most doctors aren’t even aware that their information is sold — not just by the AMA, but by pharmacies as well. When one of the 100,000 drug salespeople that blanket the country enters a doctor’s office, they know exactly how many prescriptions the doctor has written for their drug and for those of their competitors. And they know how the doctor’s prescribing habits changed since their last visit — so they can figure what messages worked, and didn’t work, with that particular doctor.
If most doctors aren’t aware of this, you can be sure that most patients aren’t aware of it either. Drug companies try to portray their salespeople as providing an “informational” and “educational” service, but that’s a red herring. The goal of the salesperson to sell their drug — not to educate the doctor on the most effective and cost-effective treatment.
It’s high time that doctors kicked the drug salespeople out of their offices and instead relied on independent information about drugs. Some doctors and medical centers have done just this. Getting Academic Medical Centers to adopt better policies about drug salespeople is one of the goals of the Prescription Project, whose director, Rob Restuccia, is one of the authors of this op-ed. (The Prescription Project is a project of Community Catalyst, which is also PAL’s parent organization)
No Free Lunch now has a directory of doctors who refuse to see drug salespeople — go here to check to see if your doctor’s name is in it. If he or she isn’t, why not ask them to take the no-drug-salespeople pledge at your next appointment?
Here’s the op-ed that ran this week:
Prescription mining raises millions for doctors’ group
Robert Restuccia and Lydia Vaias
Wednesday, July 25, 2007
Drug companies care about what your doctor prescribes just as much as you do – and they’re paying big money to find out. They are paying so much, in fact, that even though the vast majority of physicians disapprove of the sale of their personal prescribing data for marketing purposes, the American Medical Association persists in selling detailed physician information to the pharmaceutical industry. This data must be used for legitimate public health research – not brand promotion.
Drug ads cover doctors’ offices, coating everything from wall calendars and paperweights to stethoscopes and prescription pads. The numbers show that these advertisements work: doctors are prescribing more brand-name, higher-cost drugs than ever before.
One of the less obvious but more intrusive marketing tools is the drug rep’s hand-held computer, which contains a detailed profile of your doctor’s prescribing history. Armed with the knowledge of each doctor’s individual prescribing habits, pharmaceutical sales representatives tailor their pitches to each physician. This strategy has resulted in new, costlier drugs replacing established medications that have proven histories of safety and effectiveness. Industry profits swell, as do the nation’s health care costs.
Few people recognize the role the AMA plays in making physician information available to companies that use it for pharmaceutical marketing purposes. The AMA sells information from its physician “Masterfile” to health information organizations that pair the identifying information with prescribing records from pharmacies and sell the whole package to pharmaceutical companies, a practice commonly called “prescription data-mining.”
The AMA profits handsomely from this agreement. In 2005, the AMA made more than $44 million from the sale of database products, approximately 16 percent of its budget. It comes as no surprise, then, that the sale of prescriber information failed to make the formal agenda when AMA delegates met in Chicago last month.
Yet among physicians there is a growing and vigorous debate about the appropriateness of this practice and its enhancement of pharmaceutical marketing. Despite representing less than 30 percent of all U.S. doctors, the AMA keeps identifying information on all licensed physicians – and sells it all. Even so, only 60 percent of physicians surveyed by the Kaiser Family Foundation were aware of the sale of their information. Once told, 74 percent disapproved. Even a survey by the AMA itself found a 66 percent disapproval rate.
A number of policymakers, physician groups and medical societies have come out against this practice in recent years. Leaders include the National Physicians Alliance, the American Medical Student Association, the Vermont Medical Society and the New Hampshire Medical Society. Unfortunately, the AMA has a financial incentive to keep selling this information without regard to how it is being used or the impact it has on patient care and health-care costs.
A growing number of states have taken measures to end data mining because the AMA will not. Maine and Vermont recently passed legislation banning the sale of information detailing what drugs doctors are prescribing their patients while New Hampshire, the first state to pass such legislation, saw the data mining companies challenge the law. A federal court overturned the law banning the sale of prescription information “on free speech” grounds and the case in now being appealed by New Hampshire.
Last year, in response to this growing pressure, the AMA created an “opt-out” measure, called the Prescribing Data Restriction Program. Difficult to navigate, poorly publicized, with only a quarter of physicians are aware of it, and used by less than 1 percent of doctors, the opt-out program is a step toward reform, but a small and inadequate one. The program does not bar the sale of prescriber information to pharmaceutical companies; it merely requests and then relies on the industry to prevent the transmission of this data to its sales teams.
By continuing to profit from the sale of physician data, the AMA has shown itself to be at best, slow-to-act, and at worst, opportunistic at the expense of professional boundaries. The AMA should put medical ethics before profits and stop licensing its Physician Masterfile for pharmaceutical marketing purposes.
Robert Restuccia is the executive director of the Prescription Project, a national initiative supported by the Pew Charitable Trusts to end conflicts of interest created by the pharmaceutical industry’s marketing to physicians. Lydia Vaias serves as president of the National Physicians Alliance and is a board-certified general surgeon on staff at Kaiser Permanente Hospital in Bellflower (Los Angeles County).
Great article in today’s Washington Post: “Doctors, Legislators Resist Drugmakers’ Prying Eyes”. The article discusses the now-hot issue of whether the data of what drugs Doctors prescribe should be private, or whether drug companies should be able to purchase that data from pharmacies.
The article features the National Physicians Alliance, which has a new campaign on this issue (featured in our recent blog entry, “Doctors: Big Pharma is watching you!”)
In that entry, we raised the issue of whether doctors know that their prescribing data is being sold. All indications are that many if not most doctors are not aware of this. But how would most Doctors feel if they knew that the American Medical Association was selling their information to drug companies? As the article points out:
The American Medical Association, a larger and far more established group, makes millions of dollars each year by helping data-mining companies link prescribing data to individual physicians. It does so by licensing access to the AMA Physician Masterfile, a database containing names, birth dates, educational background, specialties and addresses for more than 800,000 doctors.
After complaints from some members, the AMA last year began allowing doctors to “opt out” and shield their individual prescribing information from salespeople, although drug companies can still get it. So far, 7,476 doctors have opted out, AMA officials said.
It’s not abundantly clear on the AMA website how physicians go about opting out, but this page appears to be a likely candidate.
It’s amazing how few doctors are aware — and how shocked they are to learn – that pharmaceutical companies routinely purchase their prescribing data from pharmacies. So that attractive detailer walking into the Doctor’s office knows exactly how many prescriptions you’ve written for their company’s product versus the competitors’. And they know how the Doctor’s prescribing changed since they last visited.
This allows pharmaceutical salespeople, and the pharmaceutical companies for whom they work, to target their sales pitches — that is, a doctor who’s reluctant to prescribe new drugs right after they’ve come on the market requires perhaps a softer sell than one who prescribes new drugs aggressively at the start. It also allows detailers to tailor their pitches over time — they can see what worked from their last visit right there in the data they purchase from pharmacies.
Most doctors aren’t aware that this goes on, and most patients certainly aren’t aware of it. Many, rightly so, regard it as a crass invasion of their privacy. The New Hampshire Legislature passed the “Prescription Confidentiality Act” last year banning the sale of doctors’ prescribing data for commercial purposes. That law was recently struck down by a Federal District Court, in a case brought by IMS Health and others. Prescription Access Litigation, AARP and others had filed an amicus curiae (“friend of the court”) brief supporting the law and calling for the lawsuit to be dismissed. Hopefully, the state of New Hampshire will appeal the ruling.
Enter the National Physicians Alliance, “founded to restore physicians’ primary emphasis on the core values of our profession: service, integrity, and advocacy.” They have a new campaign supporting other states’ legislative efforts to “ban the sale of physician prescribing data for commercial and marketing purposes.” See their creative 1-minute video on the issue below.
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