The Ethics of Selling Prescription Data




Health and Healthcare CategoryThe compilation and selling of physician prescribing habits has been a common practice since the 1990’s. Many physicians were unaware that the issue was occurring.

Pharmaceutical companies argue that the mining of prescribing data has beneficial uses, such as providing information about drug interactions and long-term effects, and prevention of drug errors. Pharmaceutical companies have also stated that without the use of this information, they would be less able to target educational information. Doctors would see an increase in sales calls and a decrease in needed drug samples.

FilesDoctors argue that the choice should be theirs as to whether or not their prescribing practices should be sold to drug companies. According to a national survey conducted for the AMA in 2004:

77 percent were unaware that pharmaceutical companies had access to physicians’ prescribing data, and 66 percent opposed the release of these data to sales representatives. However, 68 percent believed that the release of the data had “neither a particularly positive nor a particularly negative impact on their medical practices”; 77 percent indicated that their concern would be alleviated if they were given the choice of preventing the release of their prescribing data to sales representatives.

In 2005, the AMA claimed $45.5 million in revenue from the sale of database products. Their Masterfile contains information on 820,000 physicians (December 2004). Although it does not contain prescribing data, it does contain historical data from a doctor’s time as a medical student onward. Pharmaceutical companies can cross-reference this information with information obtained from other sources, such as internal identifiers used by pharmacies, and come up with a profile of a doctor’s prescribing history.

This is a very lucrative business:

In 2005, IMS Health had operating revenue of $1,75 billion, substantially all from sales to the pharmaceutical industry.

The AMA mitigated the situation by producing the Prescribing Data Restriction program, which allows doctors to deny access to their prescribing habits to all sales representatives and their supervisors. The web-based program commenced in May of 2006. They did not, however, stop the practice of selling their Masterfile to companies who mine the data contained within to discern prescribing data and patterns. They have justified their decision to continue licensing their Masterfile with the argument that if they do not, their revenues will decrease and pharmaceutical companies will find the information from another source.

Reference

Steinbrook, R. (2006). For Sale: Physicians’ Prescribing Data. New England Journal of Medicine, 354(26), 2745-2747. DOI: 10.1056/NEJMp068125

  • I think the really interesting part of the gathering of prescribing habit data is whether or not drug companies will use this information to “reward” doctors who prescribe, or maybe “over prescribe” certain drugs. While there have been steps taken to reduce the “gratis” given to doctors who prescribe one drug over another, one has to wonder though, if this data base of prescribing habits will be used similarly in some kind of covert reward system that ultimately benefits the doctor but not the patient.
    Good article – and something to think about ….

  • Complaining about pharmaceutical industry access to prescription information is merely a smokescreen for the real issue – that information exists at all. The real goal isn’t to stop sales reps from seeing this, it’s to ensure that the DEA can’t get ever find out what doctor’s are doing. The doctors complaining the most about this issue are the same ones with the highest instances of narcotic prescribing. And we’re not talking pain management specialists. We’re talking dentists, cardiologists and urologists.

    I’m looking forward to the day when someone can explain the medically necessity of why a cardiologist in New Hampshire is writing upwards of 8,000 prescriptions a year (that’s over 20 scripts a day, 365 days a year) for narcotics. Either the whole town is narc’d up or something fishy is going on.

    Complaining about grafts, bribes, cozy sales rep relationships, dinners, pens, free lunches, patient privacy rights and everything else is a smokescreen for the real issue – physician prescribing abuses. Backing doctors who inappropriately prescribe drugs to Rush Limbaugh, Keith Ledger and Anna Nicole Smith is fine…just be honest about it.

  • Thank you, Colette, for your comment. As for the “gratis” given to doctors, I agree with you. And I believe that it doesn’t even necessarily have to be covert. I think that anytime you reward someone with something, that person feels obligated to “give back”. I don’t think this is necessarily a conscious thing, just a human thing. And the drug companies know this.
    Again, thanks for the comment.
    Jennifer

  • Pingback: Points of Interest #22 « Mind, Soul, and Body()

  • The word that comes to mind is denial. The word that’s missing is accountability and that’s dependent on transparency. Blogs like yours and the comments they generate are a huge step in the direction of delivering accountability and transparency.

    Abd, eventually the truth will come out. And then we’ll hear the classic phrase I didn’t know .

Jennifer Bunn, RN

Jennifer Bunn, RN, is a registered nurse who has been practicing for over 15 years.
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