A bad pill for health care reform in Maine

Often when politicians take aim at the latest political health care boogeyman, they end up hurting the patient. This time, they are hurting a close family member of mine with a rare cancer.

In health care, data and information drive everything from an appropriate diagnosis to understanding and administering the latest treatment options with the best patient outcomes. When the pathway to information is blocked, so is the route to the most efficient and effective care.

Earlier this year, the Maine Legislature hastily passed LD 4, a law that will go into effect on Jan. 1, 2008. The law restricts access to prescriber-identifiable data, information about which doctors are prescribing what drugs in what amounts. Supporters of this law argue that restricting this prescriber-level data will block pharmaceutical sales representatives from using this data to persuade doctors and others to prescribing more expensive drugs.

However, the reality is that by knowing which physicians are prescribing particular medications is an efficient and confidential means in which to target those doctors treating certain types of individuals. By being able to identify physicians, those with patients who would benefit can be quickly contacted about new medications, the latest treatment research and innovation drug trials. Physicians benefit from such a system because they are provided quick access to the latest technologies and treatment approaches, while patients receive notice of every treatment option available, all in an environment that protects patient confidentiality.

Under LD 4, physicians can no longer be targeted to receive potentially life-saving information.

The benefits of prescriber data accessibility cannot be overstated. A close family member of mine here in Maine suffers from a rare form of cancer annually affecting only 2,000 women worldwide. In passing LD 4, the Legislature has created obstacles towards her best chance for recovery. Should a Maine resident be denied the well-researched level of health care and new treatments and therapies that residents of 49 other states enjoy and hear quickly about?

There are few things more politically popular than quick fixes that will allegedly cut health care costs. It easy for our elected officials to jump on board with a bill like LD 4, yet defending its merits is another matter entirely. Restricting critical information from our health care system is no cost-cutting panacea, and will create unintended consequences that do more to harm patients and drive up health care costs.

The Maine law is based on a nearly identical law passed in New Hampshire, which was ruled unconstitutional in April by a U.S. District Court judge. The minor difference in the Maine law is the “opt-out” provision allowing physicians the choice to opt-out of allowing their prescribing data to be accessed.

If physicians want a choice in sharing their prescribing information, a better option is the Physician Data Restriction Program, or PDRP. Sponsored by the American Medical Association since 2006, PDRP offers physicians the option to “opt-out” of having their prescribing data shared with sales reps. Unlike LD 4, the data could still be accessed for the other valuable purposes mentioned previously.

A recent study published in the New England Journal of Medicine illustrates the consequences of restricting information. The results of the study conducted by the Seattle Children’s Hospital Research Institute and the RAND Corp. showed that on average children received less than half of the recommended care for conditions covering 12 clinical areas. The point is clear – lack of information, or a restriction on information and available data, leads to variability of care. And variability of care negatively affects quality health care and is one of the top cost drivers.

Supporters for data restriction laws such as LD 4 argue that such laws will reduce health care costs, yet lack any evidence to prove such an assertion. In fact, the judge in the New Hampshire ruling found that the state had “failed to prove that any reductions in health care costs that might result from a ban on prescriber-level data can be achieved without compromising patient care.”

Next week, lawyers for IMS Health Inc., Verispan LLC and Source Healthcare Analytics, three companies that collect and analyze this prescriber-level data, will be in U.S. District Court in Bangor seeking an injunction blocking LD 4 from going into effect.

The court should approve the injunction and lawmakers should go back and pass meaningful health care reform measures that truly improve health care and reduce costs.

Tarren Bragdon is director of health reform initiatives at the Maine Heritage Policy Center. He may be reached through tbragdon@mainepolicy.org.