PHA-Exch> Big Pharma's "Right" to Find Out What Doctors Are Prescribing]

[Claudio Schuftan]

From: Alison Katz katz.alison at gmail.com and  CETIM cetim at bluewin.ch

crossposted from
http://www.multinationalmonitor.org/editorsblog<http://www.multinationalmonitor.org/editorsblog>

The First Amendment Gone Wild: Big Pharma's "Right" to Find Out What

Doctors Are Prescribing.   By Robert Weissman   (excerpts)



 Two crucial developments in U.S. constitutional jurisprudence -- the

grant of Bill of Rights protections to corporations, and the extension

of First Amendment protections to commercial speech -- have enabled

corporations to invoke the First Amendment to defend their right to hawk

goods, so long as they are legal, by almost any means short of outright

lying or clear deception.

 Now corporations are suggesting the First Amendment should effectively

immunize them from government-imposed rules related to the simple

commercial exchange of information.

 This new expansion of the First Amendment to block broad public

regulatory powers emerges from efforts in New England to control one of

the most insidious pharmaceutical marketing practices.

 Drug companies devote much money, and time, to influencing those

with the power to prescribe medicines -- as much as $34 billion in the

United States, more than eight times what is spent on direct-to-consumer

marketing.

The most important element of the marketing onslaught directed at

doctors is "detailing" -- the activities of the sales representatives

who visit doctors constantly, and provide free lunches, free pens, free

charts and other free goodies (including, very importantly, free

samples). The average primary care physician sees drug detailers more

than five times a day.

When a sales rep walks into a doctors office, he or she knows a lot

about that doctor -- including exactly what medicines the doctor

prescribes, and in what quantities. How can this be?

Pharmaceutical companies purchase the information from data-mining

companies, the largest of which is IMS Health. Pharmacies track what

drug is sold to each customer. IMS buys the data from the pharmacies,

deletes all patient names, combines it with data that enables the

identification of prescribers for each prescription, and aggregates the

information.

Then, when the drug company representatives cheerfully bound in to a

doctor's office, they know exactly what the doctor is prescribing. They

know if the doctor prescribes a lot of medicine or a little (drug

company reps rate the doctors on a scale of 1-10, or A-F), and whether

they go for the rep's company's product or a competitor's or a generic.

They know where to focus their efforts, and how to frame their sales

pitches.

 And, as the New York Times explained, quoting an e-mail message from a

pharmaceutical executive to company salespeople, they use the data to

"hold [doctors] accountable for all the time, samples, lunches, dinners,

programs and past preceptorships that you have paid for and get the

business!" The sales reps obviously do not have punitive power over the

doctors, but they use the prescribing information to exploit and

manipulate the social ties built on the giving relationship.

 Neither doctors nor patients consent to this use of prescribing data,

and only a tiny few even know about it.

 This is about industry surveillance of the doctor-patient relationship.

 Pharmaceutical detailing results in more brand-name and fewer generic
drugs being prescribed, at greater expense,

but there is no evidence that prescriber data "is being used to

propagate false or misleading marketing messages."



Robert Weissman is editor of the Washington, D.C.-based Multinational

Monitor, <http://www.multinationalmonitor.org>
<http://www.multinationalmonitor.org/> and director of Essential

Action <http://www.essentialaction.org> <http://www.essentialaction.org/>.
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