Cost of marketing drugs

It is not surprising that state government has been asked to become more and more involved in the oversight of prescription drugs as their cost has risen beyond the reach of many of Maine’s low- and even moderate-income families. But as Maine has learned over the past couple of years, trying to get information about drug costs so that the oversight can be effective is not easy.

Two similar bills that have been merged would make it a bit easier. LD 1167 and LD 1022 require drug companies to break down their expenses for gifts, promotions to doctors and marketing, including television advertising and printed material. Now, with both under LD 1022, it also would require drug companies to disclose the range of their wholesale prices.

The legislation may seem more intended to annoy pharmaceutical companies rather than accomplish anything, but given the enormous amount of money the companies spend marketing their products, Maine should be aware of these costs as it finds itself more often needing to pay for expensive prescription drugs. And the marketing component of is likely to become a larger portion of the total, a Wall Street Journal article noted last year, because “the pharmaceutical industry is gradually shifting away the core of its business away from the unpredictable and increasingly expensive task of creating drugs and toward the steadier business of marketing them.”

The marketing is targeted at both doctors and patients. Physicians get free meals and trips, honorariums and large supplies of free samples to help them remember which brand of drug to prescribe. Patients don’t do quite as well. Although they might get some of those free samples, mostly they have the pleasure of seeing hearty and hale actors in ads tell them about the wonders of Drug X. The Journal article estimated the industry employs 70,000 salesmen, costing $7 billion a year. It used the example of Pfizer, noting that its marketing and administration make up 39 percent of expenses, compared with 17 percent for R&D.

The Maine legislation seeks reports on how much of that money is spent in Maine and what the effects of it are. Unfortunately, the Health and Human Services Committee got hung up on whether ads placed in publications out of state and sold here would count toward that total, saw the danger of producing a lot of extra work and paper and, in a split vote, concluded the bill ought not to pass. There’s no reason for the confusion. The bill is clear enough to mean that it is interested only in ad costs actually produced in Maine, a figure that should not be hard to generate.

The full Legislature will have a chance to consider LD 1022 in the coming weeks. Some lawmakers might be reluctant to ask private businesses such as pharmaceutical companies to disclose this kind of information. Their reluctance is understandable; the requirement would be unusual, but so are the circumstances. Maine is going broke funding medical care and pharmaceuticals are leading the way. Proponents of the bill point out correctly that this legislation could spur federal rules, where taxpayer funding through the National Institutes of Health for the industry’s research make knowing where its dollars are going entirely appropriate.

That is unlikely to happen until a state goes first, however. Maine has a chance to do so in the coming weeks.