Opening eyes

Many Washington state doctors are looking to lawmakers in Olympia to protect them and their patients from the prying eyes of drug company representatives who, thanks to the Information Age, have gained influence over prescribing practices. Some doctors don’t know that their prescribing histories can be downloaded and used against them. Most patients probably don’t know, either, though what they don’t know could hurt them.

Lawmakers are beginning to catch on, and those who worry about the effects of escalating drug costs on government budgets are concerned. It’s not the affordable generic drugs that are being pushed.

Welcome to the world of “data mining,” where prescription information from pharmacies is up for sale and drug companies are eager customers. A bill in the state Legislature would bar the use of such information for marketing purposes. It would still be available for research and other noncommercial uses.

The Washington State Medical Association is pushing the bill because it says doctors are tired of sales representatives pressuring them to prescribe particular drugs.

So, you might ask, why can’t they just refuse to meet with sales representatives? The answer speaks to the complicated and sometimes unethical marriage between the medical community and pharmaceutical companies. Some doctors sit on advisory boards of drug companies. Some are paid to advocate for particular drugs. Drug companies have underwritten research without divulging that relationship in medical journals.

In a 2006 Atlantic article, Carl Elliott, who teaches bioethics at the University of Minnesota, wrote about the corrosive effects, noting that “nine out of ten medical students have been asked or required by an attending physician to go to a lunch sponsored by a drug company.” And as of 2003, “pharmaceutical companies were providing 90 percent of the $1 billion spent annually on continuing medical education events, which doctors must attend in order to maintain their licensure.”

Data mining would be less effective if the American Medical Association did not sell information from its Masterfile that allows drug companies to tie prescriptions to specific doctors.

Laws regulating data mining have been adopted in Maine and New Hampshire, but they’re being challenged by data-compiling businesses on First Amendment grounds. It is troubling for governments to regulate how information can be used once it is considered a public record. Shutting off the data completely would harm research and law enforcement uses.

The Washington State Medical Association says the real winners in stopping the marketing would be patients, because studies show that the free lunches, free samples and other gifts from sales representatives can influence doctors, wittingly or not. But the medical organization also says sales representatives help keep doctors up to date on new products and research. That such subjective sources are relied upon is also troubling.

In essence, the medical community is seeking an order of protection rather than a divorce.

The proposed bill may not be the right solution and may not survive legal challenges, but it has served to open eyes to a troubled marriage that affects us all.