The issue of privacy and accountability got a lot murkier last week when Senators Herb Kohl (D-WI) and Dick Durbin (D-IL) introduced an amendment on the Senate health reform bill that would block the sale and utilization of physicians’ prescribing information. This has been a hot topic on the state level for several years with various States (New Hampshire, Vermont and Maine) passing similar bills and various legal challenges. The Supreme Court has declined to weigh in, opening the door for this potential federal law.
The laws would pertain only to the sale and use of this information for “marketing purposes.” However, as we’ve seen in various Federal Court testimony, it is assumed that the only possible way the pharmaceutical companies could use this data is in “marketing,” so this is essentially eliminating this data stream. In the case of New Hampshire, the physicians arguing in favor of these bans have other motivations.
The doctors lobbying the hardest for this legislation are also the ones with the most to hide – physicians who have been investigated for Medicare fraud and doctors who help patients obtain opioid pain medications. These doctors are the silent and sometimes not so silent partners in doctor shopping behavior. Destroying the data stream for pharmaceutical marketing purposes will make it more difficult for the DEA and other law enforcement agencies to track criminal behavior. For the doctors in New England who have pushed this initiative, this is the ultimate motivation. This is one of the primary reasons why New Hampshire has one of the highest rates of prescription drug abuse in America (see New Hampshire Prescription Drug Abuse ).
I believe that this legislation is inevitable. The motivation of the AMA-backed doctor lobby is too strong. As physicians find their revenue streams curtailed through healthcare reform in Washington, D.C., many doctors will continue to supplement their incomes in other (and less legal) ways – notably selling prescriptions for opioid pain medications.
There is another possible implication for this. A few weeks ago, IMS announced that it would be selling itself to private equity firms for $22 a share, or $5.2 billion. IMS is one of several market research firms that provide this kind of information. If this Congressional legislation goes through, it will be interesting to see if the IMS deal goes through.