Mass. Coalition Wants Controls on Drug Marketing

Published May 1, 2008

A coalition of Massachusetts community organizations, nonprofits, insurers, and health care providers is asking the state government to regulate the marketing practices of pharmaceutical companies, claiming it will help ensure more affordable prescription drugs for everyone.

“The practice of medicine has been undermined by many pharmaceutical industry marketing practices,” said John McDonough, executive director of Health Care for All, a member organization of the Massachusetts Prescription Reform Coalition (MPRC).

“Gifts, honoraria, and other benefits distort medical decision-making,” McDonough argued. “The new coalition seeks to restore integrity to physician prescribing practices in Massachusetts by curbing industry marketing abuses.”

Some analysts, though, say advocates of marketing regulation are focusing on the wrong issue.

“Integrity is important in all aspects of health care and business,” noted Jeff Emanuel, a research fellow for The Heartland Institute and managing editor of Health Care News. “However, preventing pharmaceutical companies from advertising their products will not miraculously ‘fix physicians’ prescribing practices.’ On the contrary, it will hurt the health care industry as a whole.”

Questioning Marketing Practices

According to the coalition, the price of many of the most commonly prescribed brand-name drugs rose by nearly 50 percent between 2000 and 2007. “The pharmaceutical industry spent $29 billion on promoting and marketing prescription drugs in 2005,” reports a news release from The Prescription Project, an MPRC member organization.

“Of that, pharmaceutical companies spent more than $7.2 billion marketing directly to physicians, which is an average of about $8,800 per physician per year,” the release continued.

That figure, which encompasses advertising and marketing costs, should not be interpreted to suggest pharmaceutical companies are making payments directly to physicians.

“Preventing pharmaceutical companies from using advertising methods to make doctors and patients aware of life-saving, quality-of-life-enhancing drugs won’t bring integrity to the process,” said Emanuel.

“Instead, it will hinder doctors’ ability to carry out their professional responsibility to patients,” Emanuel continued. “Helping patients access the right prescriptions at the right time is a vital role in medicine–and it is one that is performed by medical doctors every day.”

Calling for Incentives

The coalition has asked that “the Commonwealth [of Massachusetts] take action to ensure that pharmaceutical companies do not use financial incentives to influence prescribers.” MPRC is asking for the proposed regulation to include a “data-mining ban” to prevent pharmaceutical companies from using prescription data “to micro-market to physicians.”

The third focus of MPRC’s regulatory effort is a push for “evidence-based prescribing,” under “an evidence-based physician education program that would provide doctors with unbiased evidence to guide them in their prescribing decisions.”

Stifling Speech

The coalition’s proposals are headed in the wrong direction, says John R. Graham, director of health care studies at the Pacific Research Institute in San Francisco.

“This ‘coalition’ seeks to violate constitutionally protected freedom of speech by enlisting government power to prevent pharmaceutical manufacturers from communicating the benefits of their medicines,” Graham said.

Graham notes there is no law compelling a doctor to receive a pharmaceutical salesman in his office or to attend continuing medical education courses sponsored by a pharmaceutical company.

“On the other hand,” Graham said, “there is compelling evidence that pharmaceutical research and development is linked arm-in-arm with the ability to invest in marketing and promotion. Using government power to artificially stifle spending on pharmaceutical promotion is not only unconstitutional; it threatens investors’ willingness to put their capital at risk in the research enterprise.

“Instead of trying to control drug spending by government power,” suggested Graham, we should “put more health care dollars in the hands of patients, so that they can decide how much they spend on prescription drugs.”

Sanjit Bagchi, M.D. ([email protected]) writes from India.