STEVE INSKEEP, host:
Now, every day tens of thousands of drug company representatives visit physicians to get them to prescribe the company's newest drugs. But what some doctors don't realize is that drug salesmen know exactly what drugs an individual doctor prescribes. And they use that information to hone their sales pitches. Drug companies love that data. But critics contend its use is an invasion of privacy, and Maine has just become the third state to pass a measure limiting access to that information.
Here's NPR's Wendy Kaufman.
WENDY KAUFMAN: Shahram Ahari finds himself at the center of the debate over how prescribing data should be used. Ahari, who's now a researcher at the University of California Pharmacy School in San Francisco, used to be a salesman for a major drug company. He quit after less than two years, troubled by what he calls the industry's manipulative practices.
One of those, he says, was providing salesmen like himself with detailed information about what medications an individual doctor was prescribing.
Mr. SHAHRAM AHARI (University of California, San Francisco): The drug reps can clearly see who's writing what and how much. Say we're talking about anti-depressants, what he's prescribing in terms of Prozac versus Zoloft versus Paxil versus Effexor. And we see it in terms of trends. Has he been going up with one drug and down with another?
KAUFMAN: Armed with that information, he could tailor the pitch for his drug so that it compared extremely well to the drug the doctor must often prescribed.
Mr. AHARI: The sly part of this is that I will never mention that drug by name. And the doctor is none the wiser; he's not aware that I know what he prescribes.
KAUFMAN: Drug companies get the information in a fairly straightforward way. When you fill a prescription at a major pharmacy, a record of that prescription, minus your name, is typically sold to a company which bundles information from lots of pharmacies. The bundled information is then sold to the drug companies, who give it to their salesmen.
The American Medical Association, the nation's largest physician organization, sells additional data to the drug industry. The AMA suggests that most doctors are aware what's going on. But there are many doctors who aren't or weren't until recently.
(Soundbite of knocking)
Dr. JEFF HEVNER(ph) (Washington Community Health Center): Hey, hi, everyone. How is it going?
Unidentified Group: We're okay.
Dr. HEVNER: That's good.
KAUFMAN: Jeff Hevner, a family practice physician at the Renton(ph) Washington Community Health Center, recalls the day that he discovered that a drug company rep knew exactly what he was prescribing. The salesman was in the clinic trying to market the painkiller Oxycontin.
One of Hevner's colleagues told the sales rep that none of the doctors there prescribed the drug.
Dr. HEVNER: Well, he quickly corrected her and said, no, but Dr. Hevner prescribes Oxycontin. Well, as it turns out, there's only one patient at the time in my entire practice panel who actually was taking Oxycontin. And truthfully, I almost never prescribe it, so I was shocked to find out that they found this needle in a haystack. You could almost say that Big Pharma is like Big Brother in this instance.
KAUFMAN: Hevner, like former drug salesman Shahram Ahari, is now lobbying legislators and others to limit data mining. Their argument, supported by some academics, is that private information ought not to be given to the drug companies, who use it to get doctors to prescribe new and more expensive drugs. Not surprisingly, drug companies firmly reject the idea that the use of mined data is inappropriate or that it boosts health care cost.
Ms. MAJORIE POWELL (Senior Assistant General Counsel, PhRMA): We think it's essential that anyone who is prescribing medicines have the most current information about what medicines are available, their risks as well as their benefits.
KAUFMAN: And, says Marjorie Powell, senior assistant general counsel at the industry's major trade group PhRMA, the use of physician prescribing data allows the industry to more efficiently convey information to doctors.
Jeremy Lazarus, a Denver psychiatrist who's a senior official at the AMA, thinks that's a good thing.
Dr. JEREMY LAZARUS (American Medical Association): This one that's the kind of marketing that they get to the particular specialty therein. And I think many physicians probably would find that to be helpful.
KAUFMAN: But in response to complaints from some physicians, the AMA now allows doctors to somewhat limit who gets their prescribing information. That's not enough for three New England states. New Hampshire, followed by Vermont and now Maine, have passed legislation to essentially ban data mining. The New Hampshire law, challenged on constitutional grounds, is now winding its way through the courts. Meanwhile, several other states are considering bans on data mining.
Wendy Kaufman, NPR News.
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