The pharmaceutical companies that make prescription drugs are looking over your doctor’s shoulder to keep track of how many prescriptions for each drug the physician is writing. By obtaining data from pharmacies and health insurers, the drug companies analyze the prescribing habits of thousands of doctors. That information has become a powerful sales and marketing tool for the pharmaceutical industry.
The identity of patients is not disclosed in such data, but knowing in detail what individual doctors are prescribing enables drug makers to target their messages when sales reps call on doctors. They can lobby for use of an alternative drug made by their own company, for instance, bolstering the pitch with specially selected research data or free samples.
The concern obviously is that targeted sales tactics to an individual doctor’s prescribing preferences — known as data mining — may distort decision-making and fuel prescribing of new, high-cost drugs. The result, according to critics of the practice, is increased prescribing of the newest and costliest, though not necessarily more effective, drugs.
Legislation limiting or outlawing the practice has been passed in three states, has been considered in at least 20 others in recent years and has even been floated by federal lawmakers. Many doctors have trouble finding time to examine a plethora of studies and weigh the results carefully, say critics of data mining, making them especially easy targets for drug reps armed with seemingly solid studies. And, given the rising concern over drug costs, free samples or other inducements could similarly influence decisions for non-medical reasons.
Data miners say they’re actually helping to contain costs and improve quality by quickly providing doctors with information on which treatments work best.
Legislation requiring drug makers and other health product providers to disclose gifts, travel, entertainment and other items given to physicians has been folded into both the House and Senate versions of the healthcare overhaul bill.
On the state level, New Hampshire in 2006 and Vermont in 2007, along with Maine the same year, have passed laws against the use of prescriber data in drug marketing. Depending on state laws, the bans can also apply to prescribing by nurse practitioners and dentists.
The issue is far from settled even in those states. A district court overturned Maine’s ban on the grounds that it violated drug companies’ 1st Amendment commercial speech rights, and the state is currently appealing that decision. Data firms, meanwhile, are appealing an adverse ruling in their suit against the Vermont law, and in June, the U.S. Supreme Court declined to hear an appeal of a ruling upholding New Hampshire’s ban.
The American Medical Association collected $47.6 million in 2008 by licensing its data, making the AMA’s involvement in data mining is controversial. An unspecified portion of the revenue comes from the sale of information from a master database of nearly all physicians in the U.S. to IMS and other data miners. The file contains the names of more than 800,000 physicians, including about 250,000 AMA members.