Two Pharma-related items to report:

1. Data Mining Hearing at the State House

Yesterday the Joint Committee on Health Care Financing held a hearing on several bills related to data mining (S. 17, S. 19, H. 109, and H. 110). These bills prevent pharmaceutical companies from buying doctors’ prescribing records from pharmacies and using that information to target their marketing to physicians.

Here’s our video describing the process:

Representative Provost started us off with a wonderful description of why this ban is needed. Our thanks to her for such impassioned and clear testimony!

Next up was a panel from the Massachusetts Prescription Reform Coalition (MPRC) consisting of Jessica Hamilton of HCFA, Wells Wilkinson of the Prescription Project and Jasmin Weaver from the Change to Win labor coalition. Jessica Hamilton introduced the panel and reminded the Committee that this bill passed the House last year and emphasized the need to protect patient and prescriber privacy. Additionally, she explained that the bills only ban the use of data for marketing and not for any other purpose. Wells Wilkinson then explained the practice of data mining (see our video here for the details) to the Committee. He also discussed the harms that can come to patients through the use of this data for marketing purposes. Data mining allows pharmaceutical detailers to target potential prescribers and drive up the sales of brand-new drugs. The risks of new drugs are higher than older drugs- Vioxx being the preeminent example. Next, Jasmin Weaver spoke about the need to protect patient privacy and gave the example of CVS/Caremark marketing on behalf of Merck to their pharmacy patients. When asked, by Senator Candaras, Representative Grant and Representative D’Amico, why this practice was not a violation of HIPAA, Weaver and Wilkinson replied that this practice is a loophole under HIPAA and is actually allowed. This law will close that loophole for Massachusetts.

Industry got its turn with a panel of three: Randy Frankl from IMS Health, Prof. Ernie Berndt, from MIT and Steve Mulloney from Mass Biotech. They think there is nothing wrong with the use of this information and only harm can come from the passage of this ban. Interestingly, they argued without justification that since the rate of increase in pharmaceutical costs was declining (though costs are still increasing) during the expansion of data mining, than banning the process will not save money. Malone also said that “the authors of this legislation (they are Senators Montigny and Moore and Representatives Kulik and Mariano) have a fundamental misunderstanding” of the biotech industry.

After a small discussion about provider education, Senator Moore recommended that industry become non-profits and donate money to the state’s academic detailing program so providers could get comprehensive drug information. There were no takers….In the end, Senator Moore said he wasn’t convinced by their arguments about the “benefits” of data mining.

Next we heard from a second MPRC panel with Sue Kirby (Mass. Senior Action Council), Deirdre Cummings (MASSPIRG), and Debbie Banda (AARP). Bringing the consumer perspective, Debbie Banda first spoke about the need to ban this practice so we can constrain health care costs. Deirdre Cummings explained the potential risks new medications have for patients. Sue Kirby emphasized the impact of data mining on seniors. Senator Moore asked why so many brand name drugs are prescribed when there is an automatic generic substitution law in Massachusetts. As Sue Kirby explained, the problem arises when there are new brand name drugs that don’t have generic substitutions due to small molecular changes. This means that while there are therapeutic substitutions (many of which can be generic), there is no specific generic substitution. The state law only has mandatory substitution for the exact drug, not something that is even a little bit different.

Finally, the Committee heard from David Czekanski from the state’s Group Insurance Commission (GIC), another member of MPRC. He started off by discussing some of the GIC’s statistics: their members fill over 3 million prescriptions each year. He said that despite a high rate of generic prescriptions, the GIC is still very concerned about the use of brand name drugs. Brand name drugs cost an average of 9 times more than the generics- a huge impact on their bottom line. He said that these bills support the GIC’s goals of getting the best treatment for their members at the best cost. Czekanski endured some gentle ribbing by Senator Moore about the GIC’s generic percentage (slightly lower than the state average).

And with that the hearing closed.

2. Thanks, but no thanks says APA

Doctors are telling industry ‘no thank you’ in a big way. The New York Times reports that:

Amid increasing Congressional scrutiny of ties between doctors and drug makers, the American Psychiatric Association announced on Wednesday that it would end industry-financed medical seminars at its annual meeting. The association, the field’s premier organization, said it would also phase out meals at the meeting paid for with industry money.

Each year psychiatrists, like other doctors, must attend a set number of these seminars — called continuing medical education courses, or C.M.E.’s — to fulfill state licensing requirements. But the seminars, whether given at an annual meeting or elsewhere, are often financed by drug or device makers and can be biased in favor of the sponsor’s products, experts say.

“We decided that our professional education should be entirely separate from industries that are involved in psychiatry,” said the association’s president, Dr. Nada L. Stotland, in a telephone interview.

Over the years, she said, the association has charged companies up to $50,000 for sponsoring a symposium, and some annual meetings have included 30 of them, for a total of $1.5 million. Total income from the meetings accounts for about 10 percent of the association’s $50 million annual budget, Dr. Stotland said.”

Well done APA. As we pointed out numerous times while the industry was clinging to their old model of accepting conflicts of interest, change is coming regardless of what Massachusetts does. This is another needed step in reducing industry influence on professional education.
Georgia J. Maheras