You might reasonably assume that the treatment that your doctor prescribes for you in his surgery is as private as the confessional.  But, of course, you’d be wrong.  The information is passed to health regulators who, in turn, sell it on (for a small fortune) to database companies who, in turn, sell it on (for a large fortune) to drug companies.

Eventually, this supposedly confidential information reaches the drug sales representative, who uses it to confront the doctor with his ‘misdemeanours’ – that is, all those drugs he’s prescribed that are not manufactured by the salesman’s company.

It’s a practice that began in the early 1990s.  In America, the American Medical Association last year earned $44m from the sale of prescribing information to commercial corporations such as IMS Health.  That same year IMS sold on the data for $1.75bn to the pharmaceutical industry, and made a profit of $284m on the sales.

Now, at last, doctors have had enough of being kicked around the surgery floor by the drug salesmen (and jeopardising that ‘teaching conference’ in the Caribbean once a year, sponsored by the drug company whose drugs he’s not prescribing).

In the USA, doctors are lobbying for the prescribing information to be kept away from the pharmaceutical companies.  They want new guidelines introduced that prohibit “the use of prescribing data to overtly pressure or coerce physicians to prescribe a particular drug”.  Already the AMA has responded with a Prescribing Data Restriction Program, which denies all sales representatives access to their individual prescribing data.  Unfortunately, other officers at drug companies can still get hold of the data, so it’s not impossible to imagine a scenario where the salesmen get to see it too.

IMS, which is sensing a sudden fall in profits, is teaming up with the California Medical Association to produce a programme for physicians who do not restrict access to their data so that they can see general information about the prescribing of the most popular drugs and for the most common conditions.

These measures may not go far enough.  There are rumblings to make all of the prescribing data invisible to the drug companies by enshrining consumer privacy in law.

The things that have to be done to safeguard that ‘learning experience’ in the Caribbean.

(Source: New England Journal of Medicine, 2006; 354: 2745-7).


E-news broadcast 24 August 2006 No.286 [Subscribe]