For the next 4 to 5 weeks, I am going to put together an educational primer for people interested in the Movie SiCKO, a political documentary film about pharmaceutical companies and of Food and Drug Administration by Michael Moore, scheduled for release in the United States on June 29, 2007. What is interesting is that Mr. Moore isn’t bringing up anything new….pharmaceutical and health insurance companies have been behaving like this for years. In any case, by reading this blog the next few weeks, I hope that you will educate yourself about several concepts before seeing the movie.
The concept: “Prescriber Profiling”
The players: Pharmaceutical Companies, American Medical Association (AMA), data mining companies.
How it works:The American Medical Association license access to it’s AMA Physician Masterfile, a database containing names, birth dates, educational background, specialties and addresses for more than 800,000 doctors to data-mining companies. The data mining companies, known as health information organizations (HIOs), then links this individual physician data to their demographic data and their prescription record. They then sell this linked database to sell them to pharmaceutical companies.
The pharmaceutical industry then employs approximately one sales representative for every 5 office-based physicians. A representative can quickly access a breakdown of pharmaceuticals prescribed by any physician on a handheld computer, enabling that representative to deliver a tailored marketing pitch to physicians selected for their current prescribing habits. Within weeks, the sales representative can monitor each physician’s response to the pitch—as well as to inducements, such as meals, gifts, and drug samples—and can make repeated visits to achieve sales goals. They can also identify physicians who prescribe a competitors’ drug and target them with campaigns touting their own products. Salespeople chart the changes in a doctor’s prescribing patterns to see whether their visits and offers of free meals and gifts are having the desired effect.
Critics claim that Prescriber Profiling biases the doctor-patient relationship, and it’s driving up costs. The pharmaceutical industry defends the practice as a way of better educating physicians about NEW drugs. Critics reply that this type of drug marketing serves mainly to influence physicians to prescribe more expensive NEW medicines, not necessarily to provide the best treatment.
After complaints from some members, the AMA last year began allowing doctors to “opt out” and shield their individual prescribing information from salespeople, although drug companies can still get it. So far, 7,476 doctors have opted out, AMA officials said. Some critics, however, contend that the AMA’s opt-out is not well publicized or tough enough, noting that doctors must renew it every three years. Furthermore critics claim that the AMA is reluctant to change it’s behavior because of it’s $44.5 million in revenue from the sale of database products (in 2005)—16% of the AMA’s total revenue for that year. They stress that patient names are encrypted early in the process and cannot be accessed, even by the data-mining companies.
Doctors, Legislators Resist Drugmakers’ Prying Eyes By Christopher Lee. Washington Post, Tuesday, May 22, 2007; Page A01.
Prescriber Profiling: Time to Call It Quits. David Grande. Annals of Internal Medicine. 15 May 2007. Volume 146 Issue 10. Pages 751-752.