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California Eyes Prohibiting Sale of MD Prescription Habits

Monning Takes On Big Pharma With New Bill Addressing Drug-Maker Marketing [Santa Cruz Sentinel, Calif.]

From Santa Cruz Sentinel (CA) (April 13, 2010)

Apr. 13--SANTA CRUZ -- Family physician Dean Kashino said he doesn’t mind most of the friendly pharmaceutical representatives who regularly stop by his office next to Dominican Hospital.

But he finds it unnerving that they have a record of each drug he chooses to prescribe to his patients.

"It seems odd that they can come in and say, You haven’t prescribed our medication for a while. Why aren’t you prescribing it?’" Kashino said Monday.

That’s why Kashino, with Dominican Medical Foundation, said he supports a bill introduced by state Assemblyman Bill Monning, D-Carmel, that would prohibit the sale of doctor prescription habits for marketing purposes.

For drug companies to "see which doctors are treating cancers, diabetes, that would be OK," Kashino said. "But what drugs we’re prescribing, that goes outside those bounds."

Assembly Bill 2112 goes before the Assembly’s Committee on Health today and follows efforts in other states to limit the information available to drug makers that, some say, use the data to push their products, not necessarily what’s best or most cost-effective for patients. The bill is modeled after existing law in New Hampshire.

Monning said access to a doctors’ prescribing habits allows drug companies to target physicians who might be more receptive to their sales pitches.

The California Medical Association and AARP California, among other groups, have come out in favor of the bill.

Pharmaceutical industry groups

and so-called "data mining" companies -- third-party firms that crunch and sell information obtained from pharmacies, doctor groups and other sources -- have come out against it.

Drug companies argue that possessing an individual physician’s prescribing data allows them to reach doctors quickly and directly with unique information they might not otherwise get.

"We want to make certain that doctors have the information they need to safely and effectively treat their patients," said Ken Johnson, senior vice president of Pharmaceutical Research and Manufacturers of America, based in Washington, D.C. "With safeguards in place to ensure proper use, prescriber data should be available to America’s pharmaceutical research companies so they can continue to provide important new information about medicines to the physician community."

Industrywide spending on research and development topped $65.3 billion in 2009, according to figures provided by PhRMA. The industry does not release exactly how much is spent on marketing. A 2008 study by researchers at York University in Canada estimated the U.S. pharmaceutical industry spends about twice as much in marketing as it does in research and development.

James Hinsdale, president-elect of the California Medical Association, director of trauma at Marin General Hospital and executive director of trauma at Regional Medical Center in San Jose, said his group supports the limits proposed in Monning’s legislation.

"This legislation is important because it removes one tool used by drug companies to attempt to manipulate doctors’ decisions," Hinsdale said. "AB 2112 helps protect doctors and their patients from overzealous drug companies."

Backers of the legislation say it would also help cut medical costs, as doctors are less swayed to prescribe more expensive medications. Studies done in 2007 by the Kaiser Family Foundation show that average brand-name prescription prices were more than three times that of average generic prices.

The bill proposes that those who break the law could be fined $10,000 to $50,000 for each violation.

"The argument that the sales rep is doing altruistic work in order to help the doctor make the best decision for his or her patients doesn’t hold water for me," Monning said.

He said that doctors now can quickly check online databases for peer-reviewed research of various drugs, which he said is more reliable and accurate than a salesperson’s pitch.

Monning’s bill would not completely ban the sale of doctors’ prescribing information, as that data can be crucial for medical research, law enforcement investigations or drug recall notifications, he said.

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Posted: April 2010