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Published January 22, 2008

Lawmakers pushed to stop pharmaceutical ‘data-mining’

Adam
Wilson

You might think your drug prescriptions are a private matter between you and
your doctor, but that isn’t quite the case — at least for your doctor.

Drug makers buy huge sets of information from pharmacies and the American
Medical Association. They use the information to find doctors who aren’t
prescribing their products, and send a sales representative to visit.

"You’re not really sure, because it’s not like they tell you that they
data-mined and got your information, but the way they talk to you seems to
suggest they know a lot about what you’ve been prescribing," said Dr. Beth
Harvey, an Olympia pediatrician who was approached by drug company
representatives.

"At first you feel like, how would you know that?" she said. "It did feel
kind of intrusive. When they say those things to you, they sort of implied that
you’re trying to make your patient suffer because you didn’t prescribe their
product."

State medical professionals and patient groups are supporting a bill that
would ban using doctor-specific data for marketing. They say it leads to costly
prescriptions patients don’t need.

The companies that make the drugs and that sell such information say it’s a
matter of free speech and basic business practice to promote their products.

And some lawmakers are surprised the doctors are asking the Legislature for
help in turning away sales people.

"I think it’s pretty comical that physicians would try to portray themselves
as the victims here, when they are the ones selling the information," said Rep.
Bill Hinkle, the ranking Republican on the House Health Care Committee.

The American Medical Association, a national doctor group, sells a key list
of doctor identification numbers to the drug companies. The price for the
information in 2005 was $44.5 million, according to legislative reports.

At least $3 billion is spent every year on the direct marketing, called
"detailing," according to activists on both side of the issue.

Doctors can ask the medical association not to allow sales representatives to
use their prescription records.

But many physicians don’t even know the drug companies are looking, said Dr.
Jeff Huebner of Renton.

He is part of the Washington Collation for Prescribing Integrity, which
formed this year with members including the state AARP, Academy of Family
Physicians, Group Health and the State Labor Council.

"Within the medical profession and the health care professions we’re starting
to see a cultural change," Huebner said. "Lots of us wanted to believe that the
marketing didn’t affect our prescribing practices, but the evidence is that they
do."

The doctor-specific prescription information also is used for medical
research and alerting physicians to new information such as contacting doctors
who have prescribed medications known to be dangerous when taken together.

The bills that would ban using the data for marketing would allow research
and emergency use. But industry representatives say the marketing pays for some
of that.

"If commercial use of this data (was banned), I’m sure you could understand
its effect on our incentives to collect this data at all," said Robert Hunkler,
professional relations director for IMS Health, a national broker of the
information.

Drug company lobbyists also have warned lawmakers that industry-backed
lawsuits have stopped similar bans on marketing adopted by New Hampshire,
Vermont and Maine.

"It’s pretty clear where the opposition is. In the hearing, other than drug
industry representatives and other self-interested parties, we didn’t have
people opposed. The playing field is laid out, and the question is political
will," said Sen. Karen Keiser, chairwoman of the Senate Health Care Committee.

She and the chairwoman of the House health care committee have signed on to
the ban on marketing. The Washington State Medical Association also supports it,
even though its parent group sells the information used by the drug industry.

Moving on both sides of the Legislature, the data-mining bills are part of a
three-bill crackdown on efforts by drug company marketing. The measures would
require drug companies to report gifts to doctors, and create a state-run
prescription education program for physicians.

But drug makers will always need to talk to doctors, said Cliff Webster, a
lobbyist for the Pharmaceutical Research and Manufacturers of America.

Information on individual doctors helps companies target the right people, he
said. As an example, there are 27,000 people who can write prescriptions in the
state, but only 800 wrote prescriptions for a specific HIV/AIDS drug, and of
those, just 70 people wrote four-fifths of the prescriptions, he said.

If companies can’t narrow the field, they’ll just have to market to every
doctor instead, Webster said. "I do not believe that this bill will reduce one
dime of the $7 billion this industry has spent on direct detailing, marketing
efforts."

Adam Wilson covers state workers and politics for The Olympian. He can be
reached at 360-753-1688 or awilson@theolympian.com.

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