Monday, September 17, 2007

Prescription Data Mining: A Transparent (-ly absurd) Defense by Verispan

The arguments in favor of that latest manipulative marketing technique, prescription data-mining, come in many different hues of speciousness. I recommend you visit this excellent page on the National Physician's Alliance website to learn more.

Today, however (on a tip from PharmaGossip), I read the most absurd argument in its defense yet, reported in yesterday's Philadelphia Inquirer. The reporter, Karl Stark, quoted Jody Fisher, Verispan's vice president of product management, as saying: "Doctors are trying to create a special right of privacy. I can certainly appreciate where they're coming from. But the way the world is going is toward increased transparency of information."

"Transparency of information"! What a wonderful Web 2.0 buzz phrase!

Here's what, Jody: Let's hold hands and use that argument together on the pharmaceutical companies who are refusing to reveal their payments to doctors. And while were at it, let's extend your cutting edge concept into other areas of commerce as well. For example, groceries stores can combine customer's credit card information with their bar-coded food item data to create a goldmine of "transparent" marketing information for Kraft and Proctor & Gamble. I can't wait for the smiling cereal reps to detail me. "Mr. Carlat, I was wondering if you would consider purchasing more Great Grains Selects? We have new head-to-head data comparing it to Smart Start...."

If you haven't heard about prescription data-mining yet, here's a short course. When I was a hired gun speaker for Wyeth back in 2002, drug reps would book me speaking gigs at primary care doctor's offices. My job was simple: say whatever I possibly could to get doctors to prescribe more Effexor XR.

Before each of these "Lunch 'n Learns," as they are called, the rep would fax me a little cheat sheet about the doctor we'd be visiting. This sheet spelled out exactly how many prescriptions for which antidepressants this doctor was writing. Doctors who wrote too much Celexa and Zoloft, and not enough Effexor, were crucial "targets," and I was implicitly encouraged to give these misguided doctors a particularly hard sell.

How did the reps get such detailed information? Since the 1990s, drug companies, pharmacy information companies (such as Verispan and IMS) and the AMA have been collaborating in packaging doctor's prescription information and using it to help companies more efficiently sell their drugs. Companies like Verispan buy prescription info from local pharmacies, then they purchase identifying data on all us doctors from the AMA (which makes over $40 million a year by leasing out its physician Masterfile), and finally they turn around and sell the whole package to the highest-bidding drug companies.

Most readers of this blog have probably already heard about this latest piece slime-marketing, but doesn't it make you slightly nauseous to contemplate it again? It does for me.

Well, the word about this practice has finally hit the media, and many doctors, particularly members of the vibrant new physician's organization, National Physician's Alliance , are outraged (I know, this is the second plug I've given them in this posting; here's the subliminal message: JOIN THEM INSTEAD OF THE AMA). So far, three states, New Hampshire, Maine, and Vermont, have passed legislation curtailing the practice. However, the well-funded pharmacy information companies are planning to sue each and every state that limits prescripion data-mining. They've already succeeded in persuading a New Hampshire judge to strike down the law.

Don't worry, people. The good guys are gonna win on this one--I guarantee it!


soulful sepulcher said...

Unbelievable, yet not surprising. I've been witness as a patient/consumer to a mega-Chinese food "lunch and learn" and a mega-Mexican food "lunch and learn", one at a psychiatrist's office and one at a cardio office. I think it's okay for me to say as a patient/consumer that this is disgusting, and quite possibly the reason people DIE from some of those meds that were being PIMPED by Pharma reps.

See Furious Seasons for some serious stats re: deaths and drugs.
Today, as mom and a woman, I wonder what the hell happened to me and my daughter as a result of these practices.

This is a great post, I'm sure I will link to it once the crying stops!

Anonymous said...

Your recent post, "Prescription Data Mining: A Transparent (-ly absurd) Defense" (Monday, September 17, 2007), quotes a Verispan executive as saying that,"Doctors are trying to create a special right of privacy" in attempting to stop the practice of 3rd parties mining their prescribing habits.

She further goes on to brazenly justify her company's practice by painting physicians as archaic 'holdouts' to "the way the world is going .... toward increased transparency of information." Holy cow! Like my father used to tell me, "that sure sounds good, but it doesn't mean a damn thing!"

As a publisher, I have hired companies like IMS in order to deduce what educational materials would be of interest to an individual clinician. For example, prior to introducing the journal, Primary Psychiatry, in 1994, I sat at a one of IMS's super-computer terminals for an entire day in order to cull the top 40,000 prescribers of psychotropics among the primary care universe. (Just under 200,000 doctors.) If you were a high prescriber of antidepressants, for example, you were likely to be a physician who wasn't afraid to treat psychiatric patients. These doctors became the basis of our core audience and I hope we did them an educational service. We paid a lot of money for that list; we made a lot of money in advertising revenue; and today everyone is doing it.

Even as an admitted "data miner," I cannot defend, nor even comprehend, what is going on today. We looked only at classes of drugs—such as antipsychotics, benzodiazepines, hypnotic agents, and the like, in order to get a cross-section of psychiatry-friendly PCPs. What you describe in your blog—the very idea of looking at how much Drug X an individual physician had prescribed over a given period of time is outrageous. Do you get spanked if the prescriptions go down over a given month? Conversely, does a fresh box of Arturo Fuente cigars mysteriously show up in your office before the holidays if you've been a good boy? There's no justification for ANYONE but your patients to know what you will prescribe tomorrow. If that constitutes a "special right to privacy," than so be it. As your patient, I don't want copies of the prescriptions you write me floating about to be plucked out of the air by the highest bidder.

The National Physician's Alliance may be just the thing to help solve this dilemma. A few things come to mind: 1. Educate patients that data mining is bad for them. 2. Encourage them to use local pharmacies that specifically DO NOT contribute to this database. 3. Put those pharmacy names up prominently in your waiting area. 4. Lobby patient advocacy groups to assist in curtailing this practice. 5. Require that any drug co. salesperson allowed into your office sign a prepared statement swearing that they have not looked at your prescribing habits. 6. In turn, let them know if you have increased/decreased prescriptions and why. One good turn deserves another.

This is an interesting problem that warrants creative solutions. If companies like Verispan can justify looking up your skirts because they can, hit them the only place that counts: Their pocketbooks.

I look forward to follow-ups to this debate. Good luck.

Jim La Rossa
MedWorks Media Global, LLC.
Los Angeles, CA.

soulful sepulcher said...

When I arrived at the psych ward today for a visit, there was a pharma rep towing her wheely suitcase behind her as she left the staff a full blown Chinese food lunch.

Piss off. Is what i say, whatever floats your boat or blows your dress up--this pharma shit is an industry without a conscious.Period.

Anonymous said...

It is possible, and highly likely that your employer is aware of the prescription medications you are taking and the health condition associated with the medication. Even though there are confidentiality laws in place to protect you, these laws are rarely enforced, as it is difficult to prove that an employer is using this information inappropriately or that an employment decision has been made based on a health condition. The only real way to guard your privacy is to not use the companies Rx plan to purchase medications for questionable or embarrassing conditions. This is one of the major reasons was created, to protect your privacy. See the website for details about the low membership fee and drug prices.

Anonymous said...

Buy Viagra Online in
It's a secure site, trusted and also it has the best quality and the cheaper medicines online.