Vermont lawmakers enacted the nation's strongest measure limiting the drug industry's marketing influence over physicians. The bill, S 48,
bans gifts from the industry to physicians, including meals and travel,
and requires unprecedented disclosure and transparency of relations
between the industry and providers. Said Sharon Treat, Director of the
National Legislative Association on Prescription Drug Prices (NLARx) and Maine State Representative, "Vermont now joins Minnesota and Massachusetts in tackling head-on the pervasive influence of payments and gifts on medical practitioners through a ban on many gifts.
Of the $30 billion spent each year on marketing, the drug industry directs
$7 billion towards physicians -- an average
of $8,800 towards each of the 817,000 physicians in the US. 94% of doctors have received
gifts from drug companies, including catered lunches and
"educational" conferences at upscale resorts. Studies
show that even small gifts create an unconscious "demand for
reciprocity." The 90,000 drug
company sales reps exert tremendous influence over which
drugs physicians prescribe, encouraging doctors to prescribe
more expensive drugs instead of less costly - but often equally or more effective -
medications. To counter the undue
influence of drug industry marketing, states can:
Ban Gifts & Require
Disclosure of Financial Relationships: Minnesota, in 1993, became the first
state to limit gifts from the drug industry to physicians. It bans gifts
of more than $50 and requires companies to disclose
payments to physicians in excess of $100. Several other states
have enacted disclosure laws, exposing millions of dollars spent on
payments to physicians and conflicts of interest. In 2008, Massachusetts lawmakers are considering
an outright ban on gifts as part of a broad cost and quality health care
reform bill (S.2526).
"Data-Mining" -- Protecting Prescription Privacy: In
2006, New Hampshire
became the first state to enact a ban on "data-mining" (HB 1346)
- the process by which the drug industry uses, or mines, the prescribing
habits of providers to inform direct-to-provider sales. Maine
soon passed similar laws. As
expected, PhRMA, the drug industry's massive lobby, is holding these laws
up in court, but states like Washington
and the District
of Columbia continue to press forward.
$287 billion -- that is how much the U.S. spent
on pharmaceuticals in 2007, representing a significant driver of health
care costs. While spending on hospital and physician care surpass
spending on prescriptions, drugs still account for 14% of all health care expenditures. Combine this with polls that show 70% of Americans believe the drug industry puts profits ahead of people, and it's no wonder that in 2008, at least 540 bills
and resolutions are being considered by states across the country to
reduce prescription drug prices, ensure the quality of medications
covered by public and private health plans, and reduce the undue
influence of pharmaceutical industry marketing - which itself tops out
at $30 billion each year.
Incremental steps to improve the health care system can lay the
foundation for comprehensive reform that provides health care for all.
Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but
each state does have numerous options for increasing access to
coverage, reducing the growth of health care costs, and improving the
quality of care.
Despite ongoing court challenges, states are moving ahead to protect the privacy of physicians' drug prescribing-history. Most recently, the Washington State Senate passed SB 6241, which prohibits
the sale or use, for marketing purposes, of data detailing which
drugs a physician prescribes and how often -- a practice called
data-mining. In 2006, New Hampshire became the first state to ban data-mining for marketing purposes.