NLARX: Singing the Blues in New Orleans

Several months ago National Legislative Association to Reduce Prescription Prices (NLARX) announced that their satellite symposium at the National Council of State Legislators (NCSL) in New Orleans held today, July 25, 2008 was going to be a discussion on legislative victories they had won in New York, Massachusetts and Washington, DC.

The agenda has changed in the last few weeks to:  A Shot in the Arm: New Lessons in the Battle to Save Drug Costs and Protect Patients: . Now the discussions are on the success of the panel from last year’s meeting (that’s right they had a good time last year so why not talk about it) and the 3-state New England collaboration to provide objective drug information to prescribers ("academic detailing"), legislative campaigns to ban gifts to doctors and license drug sales reps, and the latest news on federal legislation and Congressional investigations into drug marketing tactics  (apparently they want to discuss their victories in important states of Maine, New Hampshire and Vermont).

If one was going to discuss victories perhaps they would have some victories to discuss, but not this group. I guess if you have booked the room and the speakers you might as well make the best of it.

I once had a friend who went to the French War College in Paris. Another military friend made light of the fact that what they were going to learn about famous French military victories would be a short list (actually you type it in Google and it takes you to perhaps you made a mistake (see link). 

This conference promises to be the equivalent of studying famous French war victories; a lot of pride but not much for wins.

Perhaps the legislators around the country are finally waking up and realizing that pharmaceutical and device companies are not the “villains”, that they bring jobs to our states, and new medicines that eventually save lives.

At the beginning of this year dozens of bills were introduced throughout the country in state legislatures proposing everything from banning gifts to physicians (and gifts means all work), to restrictions on prescription data and disclosure laws.  Not a single state took them up (DC is a city with a corrupt city government making deciscions by local favors - you pass my bill, I will pass your bill, you want a street paved... to get a licensing of sales reps bill; “I think I will yawn”).   Massachusetts is still considering a bill that the house passed, that would codify the PhRMA code, which is a reasonable proposal by any strech of the imagination, and the provision for academic detailing is an earmark for University of Massachsetts School of Medicine not much competition or transparency here.

Fortunately, there is a Latin phrase that is my favorite in working with state legislatures and that word is Sine Die roughly translated (without a confirmed date, end of session, all open bills are dead).  At the end of every legislative session in most state legislatures they end with the two word ending “Sine Die”.

So, I am sure there is much to learn in their confernce about what could have been and why we all need “academic detailing.”  But in the end it is SINE DIE this year to all those really bad ideas.

Part of the NLARX invitation includes “Be sure to stay over Friday night so you can attend our event and the closing extravaganza featuring Cajun Zydeco music and much more”; at least they get to party to the Blues this year.  (Hey I thought legislators couldn't party, can you imagine if this was a physican meeting with a "closing extravaganza featuring Cajun Zydeco music and "much more"   --- NLARX would make announcements that because of the influcence of Zydeco music and "much more" it would be the end of medicine as we know it)

Sine Die

Comments

[Thomas Sullivan]

Readers, please forgive me, Lisa is right the earmark for academic detailing in Massachusetts is not for Mass General (as I wrote) but for the UMass School of Medicine.
Also the Senate and House in Massachusetts are working out the bill.
The people at Healthcare for All are solely focused on "saving money for prescription costs for their members" unfortunately, this does not necessarily translate to "saving lives and improved quality of life for patients"
There is room in the "middle" in which both can be accomplished. We would welcome their help in reducing the costs of development, regulation and legal actions that has driven up the cost of prescription medications, marketing is just one piece of a very large puzzle.

[Lisa Kaplan Howe]

Your synopsis of the pending Massachusetts legislation bears clarification:

- While the House passed a bill requiring that companies adopt and disclose internal codes of conduct (such as the PhRMA Code), the Senate passed a ban on all gifts (excluding samples and reasonable compensation). The Senate and House are currently negotiating which proposal (or a middle compromise) will move forward.

- The academic detailing program is not related to Mass General. The program will be run out of the Department of Public Health in conjunction with a department of UMass Medical School. These programs have been highly successful in other states at appropriately reducing prescription drug spending (producing savings that far exceed the cost of the program) and improving quality of care.