PHARMA/PHYSICIANS: Yet more on Rx data sales

The NEJM has a perspective about the sale of Rx data of physicians prescribing patterns, which caused a lot of fuss on THCB a while back. In my view this is problem about number 728 on the docket of what’s wrong in American health care, and those physicians complaining about it should look to solve the first several hundred before they set their sites on changing the law, or just kick the drug reps out of their offices. There’s nothing particularly good about the current situation but it’s just not that big a problem and banning the sale of data won’t change it too much. the perspective from Robert Steinbrook largely agrees.

Prohibiting the release of prescribing data to sales representatives will not put an end to another practice to which some physicians object: the use of such data by managed care or pharmacy benefit managers. These entities have sources of information that are independent of the AMA Masterfile. It also will not stop visits from sales agents, which doctors have always had the right to refuse, nor will it curtail the marketing of drugs. According to the AMA, the potential effects of restricted release may include a reduction in the number of “offers physicians currently receive from the pharmaceutical industry, such as drug samples, CME programs and speaking engagements.”

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  1. As an ex-drug rep, we used this data at meetings, and when calling on doctors. We would analyze who would receive inducements (bribes) according to what the data said about thier support for our company’s drugs.
    The data is possible because of the American Medical Association selling it to pharmaceutical companies, and they make about 40 million a year from this activity.

  2. Not quite getting your point here, Matt. If selling Rx data to drug companies is a corrupt practice with no upside for improving quality of care, let’s stop it. Why must every reform be ranked in order of importance?
    George’s point is also valid and can be stated more broadly. When you say that such sales are “just not that big a problem”, you’re talking through your hat. We all are. There’s little information available on how drug reps are using Rx data.
    It seems reasonable to suspect that some drug reps are abusing it in the way that George alleges. In addition, having pinpoint data enables drug reps to study which marketing practices work most effectively – not on a population basis, which would no doubt continue without rx data, but doctor by doctor.
    This is really a pretty easy call – perhaps you’re just telling us that you’re bored and you want to think about more complicated issues. OK, try this: CMA/IMS program – launch of valuable physician service or trojan horse for big pharma? Discuss.

  3. In 2005, the AMA received $44.5 million in revenue — about 16 percent of its total revenue — from the sale of database products, according to NEJM. The AMA has sold individual physicians out to corporate interests.
    Your opinion about what physicians should do about selling their prescribing data is of no particular value to anyone because you don’t support it. Steinbrook’s argument addresses a separate issue and does not support your opinion. The law should be changed because of the strong potential for corruption. Corrupt drug reps have given a variety of kickbacks in the past, according to news reports, to physicians who prescribed large volumes of certain drugs.
    Steinbrook’s point isn’t valid in any case. Insurance companies who pay for prescribed drugs must have prescribing data to make payments. Doctors may not like insurance companies not paying for certain drugs, but they can’t rationally complain that insurance companies keep track the costs of drugs that they are paying out. Insurers don’t need to get data from the AMA.
    I won’t argue that this is the biggest problem in health care today but it’s one that can be solved easily without being rude to honest drug reps.

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