Right now, large data mining companies purchase computerized prescription records from insurers and pharmacies and then sell that information to pharmaceutical companies to track every prescription a doctor writes. Selling data about what and how much is prescribed is big business – very big business indeed. In 2004, the industry spent $27 billion on drug marketing (more than any other sector in the U.S. on its sales force or media advertising), more than 85 percent of which was targeted at doctors.

LD 4, “An Act to Amend the Prescription Privacy Law,” takes a step toward restoring the focus on patients and good medical decision making. The law in no way compromises patient safety, as Tarren Bragdon claims in his misleading OpEd “A bad pill for health care reform in Maine” (BDN, Nov. 30). Indeed, the law will help protect patient safety by reducing the undue influence of pharmaceutical marketing in prescribing decisions by allowing doctors to choose to not have their prescribing information sold for use by drug marketers.

Bragdon mischaracterizes LD 4 and misunderstands the way safety information is conveyed to prescribers. The Food and Drug Administration already requires drug companies to notify prescribers of untoward side effects, new study precautions and “black box” warnings. To suggest this would not occur if LD 4 goes into effect is preposterous. The law was narrowly crafted to specifically preserve access to prescribing information for safety and health uses. Also, each board of licensure knows who is prescribing, and the federal government has access to the largest database of physicians and other prescribers. Targeting prescribers based solely on what types of medications they prescribe does absolutely nothing to further patient safety.

The Legislature thought long and hard about this legislation – contrary to Bragdon’s assertion, there was nothing hasty about it. In fact, the bill was printed in December, and in March the Health and Human Services Committee held a lengthy public hearing on LD 4, cosponsored by Sen. Lisa Marrache, and LD 828, a similar bill sponsored by Rep. Sharon Treat. The record includes testimony and peer reviewed articles from some of the country’s leading experts on health law and policy. The committee held at least three work sessions on the bills in April and May, giving advocates on both sides of the issue many opportunities to offer suggestions to fine tune them. After making findings on the need for the law, the committee voted 12-1 in support of LD 4. It was passed unanimously in both the House and Senate in June.

One reason the Legislature passed LD 4 is that alternatives do not exist. The private, voluntary “opt out” program run by the American Medical Association and touted by Bragdon is close to useless. In the federal courtroom in Bangor last month data mining company executives admitted that even after physicians enroll in the AMA program, their information continues to be sent to the data mining and pharmaceutical companies. Only the drug sales rep and her immediate supervisor don’t have access to the data – but marketing executives may still use the information to create individual prescriber profiles to develop marketing strategies or reward sales reps.

The voluntary program doesn’t address the concerns of nonphysician prescribers, including physician’s assistants, nurse practitioners or pharmacists. There is no enforcement of violations, and until urged by the New England doctors in a formal resolution, the AMA’s own Web site actively discouraged participation by suggesting that physicians opting for confidentiality wouldn’t receive free drug samples, often given to patients lacking health insurance. The AMA received 16 percent of its 2005 revenue, $44.5 million, from the sale of its physician Masterfile, which is used by the data mining companies in the creation of their lucrative databases. It is not reasonable to expect the AMA to voluntarily establish and maintain an effective prescriber opt-out system if it makes their Masterfile a less useful tool for pharmaceutical marketing purposes.

Doctors are tired of being the unwitting pawns in the ever-increasing cost of health care. Legislators are tired of seeing their constituents struggle to pay for needed medications that are overpriced and overmarketed. We hope the data miners are unsuccessful in their lawsuits to stop this law – and similar laws in New Hampshire and Vermont – from going into effect. LD 4 by itself won’t solve all our health care problems, but it is an important step in the right direction.

Sen. Lisa Marrache, D-Waterville, is a physician who is board certified in family medicine and a member of the Health and Human Services Committee. Rep. Sharon Treat, D-Hallowell, is executive director of a nonprofit organization that advocates for lower prescription drug costs.