Health Care Reform: Kohl-Durbin Amendment Ban’s Data Mining

Last week, Senators Herb Kohl (D-WI) and Dick Durbin (D-IL) introduced an amendment to the Senate health care bill that would prohibit pharmaceutical companies from using pharmacy records to track which doctors are prescribing particular medications, commonly referred as “data mining.”

The House of Representatives already passed its version of the bill, which opted to study the issue of data mining, rather than limit it. The Senate amendment bars the sale of prescribing records "for marketing purposes."

New Hampshire and Vermont already passed state restrictions on data mining, although a similar law in Maine was struck down by a district court—it has been appealed by the state's attorney general. In addition, the Supreme Court has refused to hear the case from New Hampshire.

As one article noted, the amendment “would effectively ban pharmaceutical data mining, the drug company practice of buying prescription records to target sales pitches to doctors. The Senators introducing the amendment said it will combat "harassing sales practices" and "restrain undue influence" of pharmaceutical salespersons.

Media coverage around this issue has noted companies like IMS Health Inc. and Verispan LLC, who have built multimillion-dollar businesses around gathering prescription data and selling the information to pharmaceutical companies. As usual, this coverage only talks about the dollars and not the common sense that comes along with drug companies being able to have such data.

For example, a spokesman from IMS said that interfering with data mining "has the potential to harm patients," since the information is used by federal agencies to track patient safety. Consequently, IMS Health just agreed to sell itself for $4 billion.

In addition, IMS Health emailed WSJ and noted that “Shielding the prescribing practices of physicians has the potential to harm patients because without such information, it is much more difficult to communicate with physicians about best treatment practices, new treatment guidelines and updated safety warnings for medicines.”

Data Level’s the Playing Field

Although companies such as IMS buy the information from pharmacies as a way to guide the marketing of their drugs to individuals, the records only identify doctors not patients, and doctors can choose to have their data remain private. Moreover, companies such as Pfizer Inc. and Merck & Co. Inc. who use the data to identify doctors who are prescribing their drugs, tailor their presentation to the doctor's individual prescribing habits for a reason: so they can continue to help patients with the newest treatments and breakthroughs. While sometimes this does mean more expensive medicine, this does not mean that other alternatives were not considered. Generic substitution is now a way of life with most insurance companies and ppo’s withholding payment approval on many branded drugs without prior authorization. Also several states require pharmacies to prescribe generics when available.

Opponents of data mining assert that tightening state budgets are what is causing this push to prohibit data mining. For example, many believe that as Medicaid and private insurance premiums are pressured, state legislators are trying to put all the blame on the drug industry for marketing expensive drugs over less expensive ones. As a result, many pharmaceutical companies acknowledge that without such data they will be forced to hire even larger sales forces, resulting in less money for research and development.

Points to Consider

Prescribing information provides a valuable service to companies, physicians and patients. This information helps companies focus their time and effort on those most likely to treat a condition, and prevents companies from wasting time and resources spent on discussing products with those who don’t use them. It helps physicians so that they are not discussing products that they would never dispense with sales reps and it helps patients by getting valuable information on medications into the hands of their physicians.

One other thing to consider is that in the age of personalized medicine many of the diagnostic tests that determine which therapies work on which patients are largely dependent on being able to reach out to those physicians who prescribe those drugs.

In many cancers, genetic diagnostic tests determine which therapies are most effective. If those companies are blocked from this prescriber information, the ability to get test information into the hands of oncologists treating these specific tumors will be significantly hindered, and will cost patients time and years of life.

The speed of medical information is rapid and being able to target that information is good for everyone.  It is hard to understand how this amendment will help the efficiency of the healthcare system.   

Comments

[James Thomas]

The law has to pass since the claim of the doctors and patients interests is bogus. Look to Europe and Japan, they already banned data mining, do you think that the patients there have been affected ? Data mining is just for commercial purposes, doctors get information from scientific publications, other colleagues, medical congress and so on, in most cases sales rep provide commercial support more than scientific support.

[B. Alan Bragg]

The data does not compromise patient data. It is helpful to pharma and to physicians because the products are targeted to the right audience, rather than wasting the time of physicians who do not use a particular class of pharmaceuticals or treat certain conditions. As a former pharma rep, I took great care in knowing that I was a patient safety resource for my customers - reminding physicians of key contraindications and drug interactions to be considered when prescribing. This ammendment should be voted down.