Healthy Skepticism Library item: 254

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Rapaport , L .
Doctors take on drug makers: Physicians oppose the tracking of their prescriptions for marketing purposes
The Sacramento Bee 2004 Mar 10

Full text:

California doctors want state lawmakers to give physicians the ability to stop drug companies from using information about their prescription habits in marketing campaigns.

During a state Senate committee hearing Tuesday, physicians urged legislators to pass a bill sponsored by the California Medical Association that would restrict a common industry practice known as “detailing,” or sales efforts targeted at individual doctors to influence which drugs they prescribe to patients.

Steve Thompson, lobbyist for the Medical Association, said the estimated $1.5 billion drug makers spend on physician detailing and marketing each year in California harms patients because it encourages doctors to use expensive brand name drugs even when cheaper generic equivalents exist.

“This is about physicians’ right to privacy, but this is also about stopping a practice that is disadvantageous to patients,” Thompson said.

The bill, AB 262 by Assemblywoman Wilma Chan, D-Ala-meda, would create a “do not sell list” modeled on “do not call lists” for telemarketers. It would stop pharmacies from selling prescription data of doctors who ask that their information not be used for marketing. The bill would not block disclosure of physicians’ prescription data for public health research.

Under current law, doctors, unlike patients, have no specific right to privacy. Federal law prohibits the sale of prescription data that includes patients’ names.

Drug makers, however, do not need the consent of patients or doctors to buy physicians’ prescription data. The data is collected by drugstores that fill an estimated 260 million prescriptions in the state each year.

Drug makers that purchase the information can identify individual doctors and determine the specific drugs they most commonly prescribe.

Pharmaceutical companies use the data to tailor marketing messages to individual physicians, a practice drug makers say benefits doctors and patients alike.

“Manufacturers use the data to target specific physicians with drug safety information, notify doctors about recalled drugs, and identify certain physicians for participation in clinical trials,” said Kassy Perry, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, a drug industry trade group.

Detailing is so prevalent in the industry that medical students often get training on how to handle sales pitches as part of their formal education.

Consumer and patient advocates have loudly condemned the practice as a major cause of skyrocketing prescription costs. The nation’s biggest drug makers spend more than $2 on advertising and marketing for every $1 devoted to developing new medicine, according to the advocacy group, Families USA.

In response to consumer and physician backlash against drug makers’ lavish marketing practices, most major physician groups and hospital chains have detailing policies that strictly limit the perks doctors can accept from sales representatives.

Free samples of drugs are typically allowed because doctors often give these to uninsured patients. But free steak dinners or fancy trips to tropical locales for industry-sponsored education are frowned upon, or banned outright, by most health systems.

Still, detail representatives are a regular fixture in area physician offices.

Joanne Berkowitz, an urgent-care physician at The Doctors Center in Fair Oaks, said drug sales representatives drop by her office all the time, offering, in addition to needed sample pills, all manner of pens, notepads, magnets and other gadgets emblazoned with the brand name of a drug they want to promote.

“I take only the free samples I know my uninsured patients will use,” Berkowitz said. “Almost all the stuff with their names on it, I throw out or give to my staff to use at home. I don’t want that name around the office influencing what people do.”

Some doctors concede the marketing probably works despite their best efforts to disregard its message. “We all like to think we’re not influenced, but I’m sure the drug companies wouldn’t spend all this money on marketing if they didn’t have proof to the contrary,” said Richard Pan, a pediatrician at the University of California, Davis, Medical Center in Sacramento.