West Virginia
Sale of information to drug makers questioned
CHARLESTON — With a national study calling West Virginia the most medicated state in the nation, some lawmakers are questioning the sale of information about state patients and doctors to the pharmaceutical industry.
The practice of data-mining has become a multibillion-dollar business. A legislative interim committee learned Tuesday that the American Medical Association, for instance, sells information about almost every doctor in the country for nearly $50 million a year.
Critics argue that drug makers, medical device suppliers and the like mine such data to market their more expensive brand names or products. Tuesday’s hearing did not directly address patient confidentiality issues.
“Public health is directly threatened by the commercial influences that now pervade medical education,” Dr. Jean Silver-Isenstadt, executive director of the National Physicians Alliance, told lawmakers.
Silver-Isenstadt’s group is part of a coalition that favors curbs on data-mining. She cited the Vioxx debacle to underscore the pitfalls of the highly sophisticated marketing techniques fueled by data-mining.
The arthritis medicine was yanked in 2004 after research showed it doubled the risk of heart attacks and strokes, but only after an aggressive and successful advertising campaign had made it a top-seller.
“The very distinction between marketing and education has been tactically eroded, with highly destructive consequences for patient safety, the cost of health care and the integrity of the medical profession,” Silver-Isenstadt said.
Such concerns prompted the state Public Employees Insurance Agency to order a halt to the sale of information about prescriptions doctors wrote and medicines enrollees took last year. PEIA has pushed for doctors to prescribe generic versions of drugs, when possible, to lower program costs.
“It’s counterproductive to our efforts,” Perry Bryant, a lobbyist and program official. “My main focus on the PEIA Finance Board is to see that state resources are used wisely.”
Sen. Evan Jenkins, D-Cabell, defended data mining. A member of the committee, Jenkins is also executive director of the West Virginia State Medical Association, AMA’s West Virginia counterpart.
“There are significant positive features to having this data available,” he told Bryant. “You’re not even recognizing that there’s value to be had.”
Echoing Jenkins was Robert Hunkler, an executive with leading data trafficker IMS Health. With $2.2 billion in revenues last year, IMS helps doctors and other providers make the best choices for their patients worldwide, Hunkler said.
Hunkler cited a survey by the Kaiser Family Foundation ranking West Virginia as the most-medicated state, with 17.2 prescriptions per resident. Questioning whether restricting this data lowers drug costs, Hunkler also argued it violates the constitutional speech rights of data-mining firms.
He noted that efforts by Maine, New Hampshire and Vermont to limit data-mining have been placed on hold by pending federal lawsuits. He did not mention that IMS was one of several companies suing those states.
The committee also heard from AMA officials who said their group has tried to address data-mining concerns, in part by allowing doctors to have their information removed from what it sells.
Chairman Dan Foster, a Kanawha Democrat and a physician, said afterward that the issues surrounding data-mining merit further scrutiny during the Legislature’s monthly interim meetings.
“I think it’s been demonstrated that there’s an effect on both cost and quality,” Foster told reporters.
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