Doctors targeted by marketing schemes tend to prescribe
more, newer, and pricier drugs regardless of the drug's efficacy compared
to less expensive medications - sometimes with deadly consequences. As
The Prescription Project reports,
Merck spent $209 million marketing the painkiller Vioxx, driving
up utilization before the medical community had a full understanding of
the drug's side effects. The premature
and rapid adoption of Vioxx resulted in up to 139,000 heart attacks, 40%
of which were fatal.
States can establish "Academic
Detailing" programs to save lives and reduce costs. Academic
detailing programs send highly-educated medical professionals to doctors'
offices with scientific and unbiased information about which drugs are right
for a given situation, countering the industry's direct-to-physician marketing
and sales. Studies have found that
for every dollar spent on "academic detailing," two dollars are
$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.