Victory for Consumers – Budget Preserves Restrictions on Pharma Marketing

Put Patients First.The House-Senate Conference Committee just filed the budget for FY 2012, which starts at midnight tonight (download the 314 page pdf, if you must).

We are grateful that the budget does not make any changes to current state laws restricting pharmaceutical and medical device industry marketing practices. The bill preserves the gift ban and reporting statute, which protects patients from the inherent conflicts of interest when their doctors are lavished with goodies from the drug industry. The bill also preserves the state’s law restricting the use of deceptive “discount coupons,” which the drug industry uses to push their high margin drugs.

There was speculation that these issues were one of the major holdups in getting the budget agreement from both houses.

We’re also pleased that the budget includes $93,000 for the “academic detailing” program. It’s a horrible name for a very good program, which educated physicians and other prescribers with objective information on best practices in the use of generic and brand name drugs. The program has been demonstrated to save money. The appropriation will let the program continue to limp along for 2012.

Mass Prescription Drug Reform CoalitionHCFA and the Massachusetts Prescription Drug Coalition thank the House and Senate leadership for preserving these vital consumer protections. Massachusetts will continue to lead the nation with smart, effective policies that put the public interest ahead of the profit motive in drug and device marketing.
-Brian Rosman

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4 Responses to Victory for Consumers – Budget Preserves Restrictions on Pharma Marketing

  1. Kate says:

    In response to fender’s question: Who really thinks a pen will override medical judgment?

    The issue is not so much one of ovverriding medical decision-making, but nudging it by subtly promoting branded products through small gifts and payments (and meals). There is an extensive body of research that shows physician are not immune to gift giving, and in fact the smaller the gift, the more susceptible they (and humans in general) are. In some cases, such gifts and payments have been linked to significantly higher prescribing volume of a company’s drugs. (See: http://www.nytimes.com/2007/05/10/health/10psyche.html)

    From a seminal paper by Katz and Caplan “All Gifts Large and Small” (http://www.ncbi.nlm.nih.gov/pubmed/20945262):

    “… research suggests that physicians rely heavily on detailers for information and that the more doctors rely on commercial sources of information, the less likely they are to prescribe drugs in a manner consistent with patient needs. Information provided by detailers is often biased, and sometimes dangerously misleading…In fact, researchers have found that the more gifts a physician receives, the more likely he or she is to believe that they do not influence behavior (Hodges 1995). While medical professionals may believe themselves to be “more rational and critical” than the average person (Babcock 1997; Shaughnessy 1994), the success of pharmaceutical marketing illustrates that physicians are as susceptible to target marketing as others (Coste 1999).”

    Pharmaceutical companies understand that prescribers are no more immune to these relationships than the rest of us–and to prove it, they spend billions of dollars each year marketing directly to physicians. Massachusetts lawmakers were right two years ago to safeguard against some of this influence by limiting non-educational gifts from drug companies.

    • fender says:

      Sure marketing works, thats why there is an entire industry devoted to it in all fields of life. The real question is that MD writing that Rx because of marketing that biased his/her decisions against medical necessity ( ie there was a cheaper = effective drug) or did the physician write the marketed drug b/c he knew about it or its additional befits from the FDA presented program.

      True past marketing dinner may have been filled with more sales than approved uses. A few yrs before the ban the pharma industry changed program dinner material to only FDA approved uses & data. The dinners before the ban spent 75% of the time on FDA approved slides going over the disease process in review, an expensive talk to put together, then at the end all treatments plans were discussed, including the marketed drug. Then came time for MDs & other healthcare providers to hammer the presenter with questions on the data he or she presented, especially when no sig benefit over generic were proven. this lead to a lively debate where one often leaned more about alternative treatment options by the other MDs and specialist in the audience, backfiring on the sponsor. the key here is information was exchanged, debated and discussed it was not a one way street that we see in commercials, its was an exchange, not banned.

      Also there already exists a tier system encouraging physicians to try generic 1st anyone who gets too ” biased” will stand out as not meeting generic utilization rate in his it her group practice.

      Lastly & most importantly, where is the data that this ban has saved any money?? Has generic rates risen higher have medical cost come down?? …..no ……

  2. Beth says:

    Really hilarious!! $93,000 to tell doctors to prescribe generic medicines when they already prescribe generic medicines 92% of the time, and receive payments/kickbacks from the health insurance companes (BCBS of MA) to prescribe generic medicines. Why do we need to pay someone to tell doctors to prescribe generics, when they already get paid to prescribe generics??? Sounds like we are trying to drive national policy on the backs of Massachusetts residents who are trying to make a living in the restaurant industry. Great- the HMO’s win again.

  3. fender says:

    Thanks Brian & HCFA for supporting this useless bill that has zero impact on the cost of medications, yet restricts free commerce in a open society and limits physician application of common sense. For the 3rd time, the vast majority of drug costs are related to R&D approval from the FDA , and the hidden cost of the all the drugs that fail to get to market. Doctors need to be aware of the latest medications that may help keep their patients at guideline goals and quality measures that HCFA is looking for. Generic meeds should be 1st line, but the” one size fits all” mentality that the government & HCFA supports does not work in the real world. MDs, not HCFA are responsible for reaching medical goals for their patients, such as diabetic parameters, cholesterol & HTN goals. Being aware of the latest medications is part of this, and to have formal FDA approved medical programs was one easy tool that allowed this information to be shared, discussed and debated among physicians & colleges.

    Common sense does not need to be regulated, most MDs will prescribe the branded name when the generic has side effects or the patents is not at goal on the generic. Who really thinks a pen or a note pad with a pharma tag with override medical judgment ?? Boston was supposed to be a leader in academic & medical thought & development and yet the state & HCFA treats MD as children.

    Where is the data that heath cost have come down since this law started 2 years ago? Is generic utilization higher now? show is the proof.

    When is HCFA sponsoring tort reform? lower the cost of medicine by making it less costly to practice medicine . There is real data on that just look at Texas malpractice cost and suites down by over 50% since tort reform was passed there. HCFA should be 1st in line support this in MA to help hospitals & MDs lower their fix costs and reduce defensive medicine practices .

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