Minnesota Disclosure Law Sparks Controversy

Published December 1, 2007

A law passed in 2006 requiring pharmaceutical companies to disclose financial connections to Minnesota medical practitioners is stirring controversy in the state’s medical community.

The flare-up started in August, when local media discovered the disclosure list included members of Minnesota’s Medicaid Drug Formulary Committee.

At press time, the committee, which decides which drugs will be covered by the state’s Medicaid program, was planning to discuss at its October meeting how best to disclose to the public any financial dealings with pharmaceutical companies.

Credibility Concerns

Currently, committee members do not reveal potential conflicts during the application process–they mention them only during committee discussions.

“Right now there [is] no written disclosure of conflicts of interest,” said state Department of Human Services spokeswoman Karen Smigielski. “The current practice is for members to disclose these to the committee. We are revising the process to include a written disclosure statement.”

But Richard Ralston, executive director of Americans for Free Choice in Medicine, based in Newport Beach, California, notes the payments in question, which might be used to impugn doctors’ credibility, actually improve medical care.

“Patients benefit enormously when drug companies provide the financing to make their physicians promptly aware of the available medications that can help them the most,” Ralston said.

Public Disclosure

Sensitivity to the disclosure issue became evident at the committee’s June 2007 meeting, when members were notified that from that point on, before anyone testified before the committee about a particular drug, any financial ties to the pharmaceutical company in question would be publicly announced.

According to the June 2007 meeting minutes, while the committee was discussing the antipsychotic drug Invegra, one committee member, Dr. John Simon, from Minnesota’s Creative Psychopharmacology, spontaneously stated he had no financial ties with the drug manufacturer, Ortho McNeil Jansen.

Drug companies say the law causes the unnecessary release of sensitive information. Abbott Pharmaceuticals Vice President Charles M. Brock wrote in an April 2007 cover letter accompanying the state’s required financial disclosures to Minnesota’s Board of Pharmacy, “Although Minnesota law identifies these reports as public data, Abbott considers the information contained in this report to be confidential, proprietary, and/or commercially sensitive.”

Public Review

Publicly releasing the required information would “undermine Abbott’s relationships with its contractors and consultants and allow competitors to gain a business advantage,” Brock wrote. Abbott’s disclosures are displayed along with all other companies’ online at http://www.phcybrd.state.mn.us/Payments/2006/Abbott.pdf.

The purpose behind all these transparency laws may not be what it appears on the surface, said Twila Brase, president of the Minneapolis-based Citizens’ Council on Health Care. She sees the Medicaid Formulary Committee and the disclosure issue as a bid for increased government power.

“Government health plans that pay for medications are probably trying to limit pharmaceutical companies’ access to the decision-making process,” Brase explained. “If you limit access, [the government’s] ability to ration medication is strengthened.”

Bureaucratic Decisions

An even bigger problem, Brase said, is having government bureaucracies making health care decisions in the first place.

“When you’re in the government program, then your drugs can be limited, and the medication you’re allowed can become a political decision,” Brase explained. “A government committee that does not know a person’s situation will decide whether or not the state will pay for a particular medication, and will decide whether he or she can get medication. Their decision could determine whether a patient will have to spend three to six months fighting for that medication, while all the time that drug could have improved his health.”

Fran Eaton ([email protected]) writes from Illinois.