Whose Data Is It Anyway?

"Doctors Object to Gathering of Drug Data" says an article in yesterday's Business section of the New York Times:

"Although virtually unknown to consumers, the information has long been considered the most potent weapon in pharmaceutical sales -- computerized dossiers showing which physicians are prescribing what drugs. Armed with such data, a drug sales representative can pressure a doctor to write more prescriptions for a name-brand medicine or fewer orders for a competitor's drug.

"But now a rebellion is under way by some doctors, who consider the data-gathering an intrusion that feeds overzealous sales practices among the nation's estimated 90,000 drug company representatives. Public officials are also weighing in. A vote on a state bill to clamp down on the practice is scheduled for today in New Hampshire, and similar bills have been introduced in other states, including Arizona and West Virginia.

"A Gallup Poll commissioned by the A.M.A. in 2004 found that two-thirds of doctors surveyed were opposed to the release of such data to pharmaceutical representatives, and that 77 percent felt that an opt-out program would alleviate concerns about the release of data. Nearly a quarter of the doctors were not even aware that the pharmaceutical industry had access to such information."

New Hampshire HOUSE BILL 1346 states:

Records relative to prescription information containing identifiable patient and prescriber data shall not be used, transferred, licensed, or sold by any pharmacy benefits manager, insurance company, electronic transmission intermediary, retail, mail order, or Internet pharmacy, or other similar entity, for any commercial purpose, except for the limited purposes of pharmacy reimbursement, care management, and utilization review by the patient'’s insurance provider or the provider'’s agent. Commercial purpose includes, but is not limited to, advertising, marketing, promotion, or any other purpose that could be used to influence sales or market share of a pharmaceutical product, influence or evaluate the prescribing behavior of an individual health care professional [my emphasis], except for evaluation by an insurance provider or the provider'’s agent for the purpose of compliance with the provider'’s formulary, or evaluate the effectiveness of a professional detailing sales force.

Once in a while I feel the pain of pharmaceutical marketers who are being challenged on every front and who think that there's an organized effort by "woolly-headed" (ie, liberal) critics to stop pharmaceutical marketers in their tracks (see, for example, "Clash!"). In this case, however, I feel the pain of physicians but agree with Robert A. Musacchio, the A.M.A.'s senior vice president for publishing and business services, who said "What we've always stressed is that physicians have rights and they can always tell pharmaceutical representatives that they don't want to be called upon."

Of course, the A.M.A. isn't exactly a disinterested party. They make plenty of money -- $40 million a year -- selling physician data to third parties (most of which ends up for use by pharmaceutical companies). While this is not prescribing data, it is useful demographic and business data that can be combined with prescribing data to segment physicians for marketing and sales purposes. Some physicians might argue that such segmentation helps pharmaceutical companies deliver the most relevant information to them.

Just as there is a way physicians to limit the release of AMA's data about them, there should be a way for physicians to opt out of having their Rx data sold for marketing purposes. This may be a better solution than a blanket law -- such as NH HB 1346 -- which prevents it outright.