READING YOUR PRESCRIPTIONS

By buying prescription records and combining them with medical association data on physicians, pharmaceutical firms, according to a former drug representative in a news story last year, have “our greatest tool in planning our approach to manipulating doctors.” And that, a Bangor cardiologist recently told the Legislature’s Health and Human Services Committee, is just what’s happening in Maine.

Dr. Benjamin Schaefer was testifying in support of a bill that would limit the collection of this data to such reasons as research, quality assurance and product alerts, but restrict it from being used for commercial purposes. Rep. Sharon Treat, D-Farmingdale, is sponsoring the bill, LD 838, and for anyone concerned about the high prices of prescription drugs, this is one small way to hold them down, if done carefully.

Armed with doctors’ prescribing information, drug reps report they know who to target with what information, how their tactics are working and where further opportunities to urge the use of more expensive name-brand drugs even where generic drugs might work as well. Dr. Schaefer raised questions about safety with the use of new drugs and pointed to studies that found evidence of the drug industry promoting off-label use of new medications.

LD 838 is careful to make exceptions as it extends to physicians the privacy provisions available to individuals. For instance, the bill offers exceptions related to dispensing drugs, utilization and care management. Nonetheless, the Health and Human Services Committee will hear about possible complications, much as New Hampshire lawmakers did before passing similar legislation last year. They will hear that Maine already has an opt-out provision for physicians who can follow the paperwork trail and stay on top of the issue, and that an opt-in provision, in which physicians would have to give consent to have their data used, is too cumbersome.

No one wants to deny those who need it to improve health the medical information derived from prescribing patterns, so if the committee is less than comfortable with banning the commercial use of this information it can still take a couple of useful steps to address the issue. It can, for instance, establish a public opt-out system for physicians overseen by the attorney general and include a substantial fine for companies that violate it. It should also monitor New Hampshire’s experience, which started last summer. A report back in the second session of the Legislature could point the way for what Maine should do.

Such a study on its own, however, isn’t enough. The effect of prescription drug data mining on patients shouldn’t be acceptable to lawmakers or medical associations. The committee can start to improve this costly situation through LD 838.