ABBOTT LABORATORIES DELETES SAFETY CONCERNS FROM WEB Washington, D.C., August 29, 2007 – Newly available data show that employees of Abbott Laboratories have been altering entries to Wikipedia, the popular online encyclopedia, to eliminate information questioning the safety of its top-selling drugs.
In July of 2007, a computer at Abbott Laboratories’ Chicago office was used to delete a reference to a Mayo Clinic study that revealed that patients taking the arthritis drug Humira faced triple the risk of developing certain kinds of cancers and twice the risk of developing serious infections. The study was published in the Journal of the American Medical Association in 2006.
The same computer was used to remove articles describing public interest groups’ attempt to have Abbott’s weight-loss drug Meridia banned after the drug was found to increase the risk of heart attack and stroke in some patients.
The site’s editors restored the deleted information, but Abbott’s activities illustrate drug companies’ eagerness to suppress safety concerns, said Jeffrey Light, Executive Director of the Washington, D.C.-based advocacy group Patients not Patents. “The argument that drug companies can be trusted to provide adequate safety information on their own products has been used by the pharmaceutical industry to fight against government regulation of consumer advertising. Clearly such trust is misplaced. As Abbott’s actions have demonstrated, drug companies will attempt to hide unfavorable safety information when they think nobody is watching.”
The changes are part of over one thousand edits made from computers at Abbott’s offices. The data was obtained from WikiScanner, an independent site that allows users to look up anonymous changes to Wikipedia articles.
Medicare Part B has long paid for drugs that are given in a doctor’s office, such as drug treatments for cancer. Until 2005, the price that Medicare paid to doctors for these drugs was based on figures called “Average Wholesale Prices,” or AWP. In 2003, Congress created a new system for reimbursing doctors for these drugs, based on “Average Sales Prices” (“ASP”). ASP is “the weighted average of all of the sales of the drugs to all purchasers.” In 2005, Medicare began paying doctors 106% of the ASP for a drug given in the doctor’s office.
Why did Congress force Medicare to stop using AWP? It became increasingly clear that AWPs were often artificially inflated by drug companies to increase how much doctors earned by prescribing them, and thus to increase sales of those drugs. Several PAL coalition members are plaintiffs in a massive national class action lawsuit alleging that dozens of drug companies did just that. The case is In re Pharmaceutical Industry Average Wholesale Price Litigation, and is before Judge Patti B. Saris in the U.S. District Court for the District of Massachusetts. More on that case can be found here. Judge Saris recently issued a decision finding that Astra Zeneca, Bristol Myers Squibb and Warrick Pharmaceuticals had in fact illegally inflated and manipulated the AWPs of a number of drugs covered by Medicare Part B.
Industry and physician groups predicted that the amount Medicare would pay them for these drugs would be less than what doctors paid for them in the first place. The Office of the Inspector General (“OIG”) recently issued a Report finding that most physician practices that treat cancer patients generally purchase drugs at costs less than the Medicare reimbursement rates.
Despite the predictions of groups like the Community Oncology Alliance, American Society of Clinical Oncology and American Society of Hematologists, the report found that Medicare’s reimbursement rates were generally adequate for the purchase of cancer drugs. The study found that nine of the twelve physicians offices studied were able to buy most of the fifteen cancer drugs examined at or below the Medicare-established reimbursement rate.
One of the arguments that industry and physicians groups had made against the switch was that the rate that Medicare paid doctors for administering the drugs was not enough, and that any “excess” in the reimbursement for the drug itself helped even this imbalance out. So the report also looked at whether physicians’ offices had in place procedures to track how much it actually cost to administer the drugs. The study found that more than 91% of the physicians offices studied (11 out of 12) could not show how much it cost them to administer these drugs. The study pinned the problem on the fact that federal regulations do not require physician practices to track administrative costs. Without knowing how much it costs to administer such drugs, it’s impossible to determine if Medicare is paying doctors enough (or too little, or too much) for these services.
There’ve been anecdotes since this change about doctors not giving these drugs to patients in their offices because the doctors allegedly lose money when they do so, but rather, sending them to hospitals to have the drugs administered. It generally costs Medicare much more to have this done in hospitals rather than doctors’ offices. But unless doctors can demonstrate that they are not being adequately reimbursed for these procedures, their claims will fall on deaf ears.
In sum, the shift from AWP to ASP so far appears to be bringing Medicare’s payments to physicians for drugs administered in their offices in line with what it actually costs physicians to buy those drugs. Whether or not physicians are being paid enough by Medicare for administering those drugs is still an open question – but physicians need to actually document how much it costs to administer them if they want to argue for increased payments from Medicare, and not merely state they are not being paid enough.
AP reported on August 17 that the Pharmaceutical Research and Manufacturers of America (PhRMA) spent $10.7 million in the first half of 2007 to lobby the federal government. PhRMA is headed by the former member of Congress, Billy Tauzin. While in office, Rep. Tauzin was one of the main proponents of the passage of the legislation that created Medicare Part D, which is widely regarded as an enormous giveaway to the pharmaceutical industry.
Pharmaceutical companies and their trade groups spend large amounts on federal lobbying. The Center for Public Integrity issued a report in April 2007 documenting that they “spent a record $155 million lobbying the federal government and its agencies from January 2005 to June 2006.” The Center had previously reported that “since 1998, the top 20 drug companies, their subsidiaries and two industry trade groups have spent more than $650 million on lobbying. During this same time period, the industry’s top trade group, the Pharmaceutical Research and Manufacturers of America (PhRMA), spent $104 million on lobbying.”
In addition, donations in 2006 to federal political candidates from PACs and individuals associated with pharmaceutical companies exceeded $19 million. Since 1990, the industry has donated more than $139 million to federal candidates.
It is hardly surprising, given this largesse, that Congress and federal agencies are so obliging of PhRMA and so frequently adhere to its agenda. It has been more than 2 1/2 years since Vioxx was withdrawn from the market, yet no meaningful reform of drug safety has yet been enacted.
Until Congress weans itself off of drug company cash, no significant changes to how prescription drugs are reviewed, approved, monitored, advertised or priced is likely to be forthcoming.
Here’s the AP story:
Drug trade group spent $10.7M lobbying
Aug. 17, 2007
WASHINGTON (AP) – The Pharmaceutical Research and Manufacturers of America spent $10.7 million in the first half of 2007 to lobby the federal government, according to a disclosure form.
The group, known as PhRMA, lobbied on issues related to Medicare, patent reform, international trade and drug fees, importation and safety, according to the form posted online Tuesday by the Senate’s public records office.
The group — whose members include Amgen Inc. (NASDAQ:AMGN) , Eli Lilly & Co. (NYSE:LLY) and Pfizer Inc. (NYSE:PFE) — lobbied Congress, the Food and Drug Administration, the Health and Human Services Department, the Centers for Medicare and Medicaid and other agencies.
Former Louisiana Rep. Billy Tauzin, who is PhRMA’s president and chief executive, is also a registered lobbyist for the group.
PhRMA’s other registered lobbyists include: Mimi Kneuer, who was Tauzin’s former chief of staff, Amy Efantis, former legislative director for Rep. Artur Davis, D-Ala., Valerie Jewett, former legislative director for Rep. Rodney Frelinghuysen, R-N.J., and Matt Sulkala, who was senior legislative assistant to Rep. Allen Boyd, D-Fla.
Under a federal law enacted in 1995, lobbyists are required to disclose activities that could influence members of the executive and legislative branches. They must register with Congress within 45 days of being hired or engaging in lobbying.
Jane Brody’s column today in the NY Times, “Cutting Cholesterol, an Uphill Battle,” is an excellent overview of the lifestyle changes that one should make to lower high cholesterol, BEFORE resorting to prescription statins (Lipitor, Crestor, Zocor, etc).
In addition to the very useful specific advice that she offers (below), perhaps the more important message of her column is “don’t turn to a pill first.” The ubiquitous TV ads for statins, including the ones featuring Dr. Robert Jarvik, have convinced millions of people that all they need to do to lower their cholesterol is take a statin — and an expensive brand-name one at that. Statins can be very helpful and there are no doubt millions of people who can and do benefit from them. But our culture of a “pill for every ill” has given short shrift to the important — but often harder — changes in diet and exercise. The upside is that a better diet and increased exercise have countless other benefits beyond just reducing cholesterol. But when was the last time you saw an ad that said “Ask your Doctor if Broccoli is right for you.”
Even people who do need statins don’t necessarily need the most expensive, newest brand-name ones. Visit Consumer Reports Best Buy Drugs’ report on statins to see which statins are the “Best Buy” and right for different types of patients. Best Buy Drugs reviews a number of different categories of drugs, including drugs of heartburn, migraines, depression, diabetes and others.
Here’s Jane Brody’s advice:
These are the measures that have been found to work, based on randomized, controlled clinical trials, the gold standard of clinical research.
Alcohol. Consuming one or two drinks a day can lower LDLs by 4 to 10 milligrams. Red wine is considered most effective. For those who cannot drink alcohol, purple grape juice may be a reasonable, albeit less effective, substitute.
Exercise. Aerobic exercise, like brisk walking, jogging, cycling and lap swimming, can reduce LDLs by 3 to 16 milligrams and raise the good HDLs. Consistency is important. Aerobic activities should be performed at least five times a week for maximum benefit.
Weight loss. When achieved through diet and exercise, weight loss can reduce LDL levels by as much as 42 milligrams. When achieved through drug therapy, weight loss has been associated with an LDL drop of 10 to 31 milligrams.
Yoga and tai chi. These forms of exercise, which are accessible to just about everyone who can walk, even the elderly, have reduced LDLs by 20 to 26 milligrams when done for 12 to 14 weeks.
Smoking. An analysis of several studies found that LDL cholesterol was 1.7 percent higher in smokers, but two smoking cessation studies found little or no difference. In any case, smoking is a strong independent risk factor for heart disease and sudden coronary death, so it is best avoided.
Modifying Your Diet
About 85 percent of the cholesterol in your blood is made in your body. The remaining 15 percent comes from food. But by reducing dietary sources of saturated fats and cholesterol and increasing consumption of cholesterol-fighting foods and drink, you can usually lower the amount of harmful cholesterol in your blood. My college roommate, for example, recently adopted a mostly vegetarian-and-fish diet, minus cheese but with occasional meat and chicken, and lowered her total cholesterol from 240 to 160 milligrams.
There are exceptions, of course, and I happen to be one of them. Still, I intend to continue to follow a heart-healthy diet, because that will enhance the effectiveness of the medication I’m taking.
Start by switching to low-fat and nonfat dairy products, like skim milk and, if you can stand it, fat-free cheese. Substitute sorbet, sherbet or fruit ices for ice cream, or choose ice milk or ice cream with half the fat.
For protein, choose fish and shellfish, poultry without the skin and lean meats, all prepared with low-fat recipes. Eat more dried beans and peas (cooked, of course), soy products like tofu, and nuts like walnuts and almonds. Grains should be mostly or entirely whole — 100 percent whole wheat bread and cereals made from whole wheat or oats, brown rice, bulgur and the like. Oats and oatmeal are rich in soluble fiber, which lowers cholesterol.
Pile on the vegetables and fruits. Especially helpful are those high in fiber like Brussels sprouts, cabbage, spinach, carrots, blueberries, oranges and apples.
Cook with canola or olive oil, and use margarine made from plant stanols.
And enjoy a glass of wine with dinner.
Equally important are the foods to limit or avoid: organ meats like liver, egg yolks, most fried and fast foods, doughnuts and pastries, full-fat cheeses and ice cream, processed meats like salami, bacon and other fatty cuts of pork, and untrimmed red meats.
The New York Times today published an article by Alex Berenson, “Plaintiffs Find Payday Elusive in Vioxx Cases”. The article gives a good overview of Merck’s legal strategy of refusing to settle any of the cases alleging that Vioxx caused plaintiffs’ heart attacks. Vioxx was Merck’s arthritis drug that was withdrawn from the market in 2004 due to increased risk of heart attacks.
Tens of thousands of lawsuits were filed by patients and their heirs (when the patients had died of heart attacks), accusing Vioxx of having caused their heart attacks and Merck of having hidden the risks of Vioxx despite allegedly knowing about them for several years before the drug was finally withdrawn. Faced with potential legal liability in the billions, Merck decided to refuse to settle any cases, on the notion that early settlements would only encourage more lawsuits to be filed, whereas if Merck won early cases, it would discourage new cases and convince lawyers to withdraw cases that did not seem promising.
Merck’s win-lose record thus far is mixed. It won several cases at trial, but lost several more, with juries awarding millions of dollars to those plaintiffs. Predictably, Merck has appealed each and every one of those judgments, and, as the Times article describes, the net result is that not one Vioxx plaintiff has received a penny to date.
This article underscores the imbalance of power that faces consumers and patients in the Courts when they face large corporations with exponentially greater resources to fight a legal battle. Even consumers with strong and well-documented cases can in the end be deprived of justice by virtue of having to wait years and years as appeals are exhausted:
So far, fewer than 20 Vioxx suits have reached juries, an average of 9 in each of the last two years. At this rate, the backlog of Vioxx cases will take years to work through and many plaintiffs may die before they get their day in court.
The article quotes one plaintiffs’ lawyer:
“Merck’s goal is to manipulate the legal system to deprive justice to tens of thousands of people whose cases can never be heard,” said Mr. Lanier, the lawyer who represented Mrs. Ernst. “Justice delayed is justice denied.”
Merck has also resisted the consolidation of many of the individual lawsuits into a single class action. Such a process is not uncommon in prescription drug cases, particularly when there is a core set of facts that is common to all the plaintiffs. By combining the claims of numerous plaintiffs, class actions help prevent large corporate defendants from employing the types of strategies that Merck has used in Vioxx. The pressure to consider settlement, for example, is much greater in a case with thousands of plaintiffs and combined potential liability of billions, because the stakes of a loss at trial are exponentially higher.
In addition to the more than 45,000 personal injury and products liability lawsuits, there are also individual and class action lawsuits on behalf of consumers, health plans, union benefits funds, and others, not based on heart attacks, but based on the fact that Merck allegedly deceived patients, physicians, and payors about the risks of Vioxx, causing them not only to pay for a drug that might not have otherwise paid for, but to pay a premium price for it. Members of Prescription Access Litigation are involved in several of these class actions, which you can learn more about here.
WebMD reported last week on a new study in the journal Sleep. The study found that doctors are widely prescribing sleeping pills and other drugs to children having sleep problems. An astonishing 81% of the 18.6 million doctor visits studied included a prescription being written. By contrast:
They found that diet and nutritional counseling were advised for 7% of children and that 22% were prescribed behavioral therapy such as psychotherapy and stress management to relieve the sleep problems. For 19% of children, both behavioral therapy and medication were advised.
The data studied only go til 2004. Advertising for sleep drugs has exploded since 2004. Both Lunesta and Rozerem were introduced after that time, and have been extremely heavily advertised. Ambien CR was also widely advertised in that time period, both to compete against these new drugs, and to get patients to switch from Ambien to Ambien CR before generic versions of Ambien came on the market. (In 2006, we gave one of our coveted Bitter Pill Awards to the makers of both Lunesta and Ambien/Ambien CR – the “The While You Were Sleeping Award: For Overmarketing Insomnia Medications to Anyone who’s ever had a Bad Night’s Sleep”) It is likely that the enormous promotion of prescription sleep aids in the past 2 and 1/2 years has increased the number of kids being prescribed drugs for sleep even more.
Several things about these findings are disturbing:
It suggests that doctors are rushing to medications, and not adequately addressing underlying causes, or emphasizing behavioral changes and “sleep hygiene.”
Many of the drugs being prescribed have not been tested on children, and are not FDA-approved for use in children — this is so-called “off-label” usage. While off-label prescribing is quite common (one study found that 1 in 7 prescriptions was for an off-label use), it is potentially more troubling when it is done for children. Children are not “little adults” — it cannot be assumed that a drug will work the same, or that side effects and risks will be similar for children as they are for adults. The effects of drugs on children’s growth and development is unclear if the drug has not been studied in children and is not approved for use in children.
It exposes children to the risk of addiction or dependency. Many drugs used for sleep problems have these risks, even those that are not specifically approved for insomnia.
It introduces children at an early age to the dangerous idea that there is a pill for all their problems, and that taking prescription drugs is “no big deal,” and just a routine part of everyday life. This cultural attitude has contributed to the extremely troublesome and widespread trend of teenagers and young adults misusing and abusing prescription drugs.
For some children, the use of a prescription drug may be the appropriate route for addressing a sleep problem. Insomnia and other sleep problems can and do interfere with children’s growth, learning and behavior, and need to be addressed. But it is a sad commentary that millions of children are being prescribed prescription drugs, when for many of them, changes in diet, routine and schedule would work just as well and not expose them to the risks, known and unknown, that come with these prescription drugs.
Frequent readers of this blog are familiar with “Pharmie” (above), your guide to all things pharmaceutical. “Ask Pharmie” started as a feature in PAL’s newsletter, which was printed approximately quarterly until the end of 2006. (Archive issues are here.) We’ve now shifted from a printed newsletter to this exclusively online publications (including this blog), but Ask Pharmie soldiers on, committed to shining light on the pharmaceutical industry.
Pharmie answers readers’ questions about the pharmaceutical industry, drug marketing, drug pricing, and the like. He does not answer medical or treatment questions, or render medical advice. We encourage readers to send their questions to Pharmie. You can also post your question in the comments to this post.
The Southern supermarket chain Publix announced today that it will be offering seven common prescription antibiotics for free in its stores, located in Flora, George, South Carolina, Alabama and Tennessee. The move was reported in an AP story and in the Palm Beach Post.
The move follows on the heels of similar moves by other retailers, to offer selected generic drugs at low cost. Last year, for instance, Wal-Mart annoucned that it would offer a list of certain generic drugs at $4 per prescription.
What’s wrong with offering consumers free drugs? After all, many people, particularly people without insurance, have a hard time paying for prescription drugs. So free drugs will help them, won’t they?
It is true that free or discounted prescriptions can help patients, particularly the uninsured and low-income. But there is something peculiar and potentially disturbing about Publix’s move: The selection of antibiotics as the drugs to be offered for free.
Antibiotics are typically used for short periods of time to treat acute infections. Unfortunately, antibiotics are also massively overprescribed, which leads to the increase in infections which are resistant to common antibiotics. (See this June 2007 Denver Post article for more on the dangers of that resistance) The Palm Beach Post raised this concern in its article on the announcement:
Some public health officials have raised concerns about increasing use of some antibiotics because their overuse causes them to become less effective as the bacteria they target develop immunity.
The Publix initiative might contribute to that if doctors were to respond by increasing the number of prescriptions they write for the particular antibiotics the company is offering for free, said Lisa McGiffert, a health policy analyst for the Consumers Union, publisher of Consumer Reports, which has raised some concerns about antibiotic resistance
Another factor contributing to antibiotic resistance is patients not finishing the antibiotics they’ve been prescribed. It is still all too common for patients to stop taking their antibiotics when they begin to feel better. This allows bacteria to develop resistance to that particular antibiotic. It is a well-established principle of both economics and psychology that people’s perception of the value of a good relates to how much they paid for it — Thus, a patient who had to pay for their antibiotics is perhaps more likely to actually finish taking them, on the notion that “I paid for these pills, I don’t want to have wasted that money.”
The antibiotics being offered for free by Publix are all generics, and are not expensive compared to other prescription drugs. On drugstore.com, for instance, the cost of an illustrative prescrpition of 6 of the 7 antibiotics (oddly, Penicillin could not be found) covered by the program was:
The only one that was more than $12 was Cipro, which became famous several years ago during the Anthrax scare. $113.65 certainly isn’t cheap, but other forms of Cipro that patients frequently use are cheaper – for example, drugstore.com lists Cipro eye drops (0.3% Solution 2.5ml Bottle) at $15.99.
Since antibiotics are typically taken for a short period, this amounts to a very modest one-time savings. This underscores that this is mainly a marketing move, something which Publix more or less admitted in the Palm Beach Post story:
“No one else is doing this,” Publix spokeswoman Anne Hendricks said. “A couple of competitors offer low-cost. We have never been about that. We are always looking for ways to differentiate ourselves from the competition.”
The Lakeland-based company has 907 stores. In addition to Florida, Publix operates groceries in Georgia, South Carolina, Alabama and Tennessee.
With health care costs one of the biggest challenges facing many Americans, Crist said that the private sector’s involvement in the solution was “a great trend.”
Jenkins acknowledged that increasing pharmacy sales was a part of the company’s motivation but said the company also wanted to contribute to that trend.
“Frankly, we’re interested in building our pharmacy business,” Jenkins said. “But moreover, we want to help the citizens of our state have affordable health care, and we thought this was just a good start in doing that.”
The one-time savings this program represents does nothing to address the more serious problem of patients not having insurance or not being able to afford medications that they must (or should) take on an ongoing basis, such as medications for high blood pressure, diabetes, and other chronic conditions. The real cost obstacles in prescription drugs are not in generic antibiotics.
Just as the discount programs at WalMart and other chains did, it is likely that these free antibiotics will function as a “loss leader,” drawing people into Publix, where they will inevitably purchase other non-pharmacy items. Whether it will do anything of significance for people without drug coverage is much less certain.
One option for people without insurance is a Patient Assistance Program that offers steeply discounted generic drugs — www.Rxoutreach.org
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).
A new song called Pillagers by New Jersey rappers Sudden Death pokes fun at the pharmaceutical industry. The song spoofs the constant barrage of advertisements for new drugs and contains a mock ad for a fictional product called Liquiplox. The song quickly became a number one hit on the nationally syndicated Dr. Demento Show.
Hardyston, NJ, July 21, 2007 –(PR.com)– A new song by New Jersey rap group Sudden Death takes aim and fires at drug companies and their seemingly endless barrage of new products. The song, called Pillagers, tells the story of a man who is taking about two dozen pills for things from flatulence to soft eyeballs and who has been told by his doctor that he must now take another pill for his mood swings. Meanwhile at the drug company the board of directors is brainstorming about new products they can sell to keep their stock price up because the projected $7 trillion in sales of their new product isn’t enough. The result is Liquiplox.
Liquiplox, much to the man’s relief, isn’t a pill. It’s a “liquid solution that relaxes the lining of your throat making it easier to take pills.” Of course this great product comes with a host of side effects which are told in rap form.
“Side effects include headache, runny nose, drowsiness and a rash/ a sugar high, bloating, and an absence of cash/ vomiting, abdominal cramps and diarrhea/ and an overwhelming urge to buy a couch from Ikea.”
“I really had fun with the side effects,” says Tom Rockwell, author of the song and Sudden Death’s front man. “A lot of the things that are said are things that I’ve actually said to the television while mocking some of the drug commercials that I’ve seen.”
“Liquiplox isn’t for everyone. People without health insurance or who otherwise may be unable to pay should not take Liquiplox,” the song says. “Do not stop taking any of your other medications without consulting your doctor as this may cause an unsafe drop in our profit margins.”
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