From The College July 2006

The complete newsletter is available in PDF format, below.

Featured Article

Do You Know Who’s Counting your Prescriptions?

All physicians are familiar with pharmaceutical company sales representatives, even if they don’t meet with them on a regular basis. Dropping by regularly to discuss their latest products and leave samples, sales reps are a common sight in the office for most physicians.

What might surprise you is how familiar the pharmaceutical representatives are with you and your prescribing practices. Every time a physician writes a prescription, this data is tracked by Healthcare Information Organizations, who then market this data to pharmaceutical companies for commercial purposes. Physician prescribing data protects the anonymity of the patient per HIPAA rules, but not the anonymity of physicians. As Peter Kent, MD, a member of ACR’s CORC, observes, “When you become a physician, no one tells you that sales reps have this data about how many prescriptions you’ve written. You find out from talking to them, and I’m sure that it annoys physicians.”
In addition to being used as the basis of a reward system, some companies have gone a step farther – too far, in the opinion of many doctors – and used the data to confront physicians about their prescription practices.
Many physicians weren’t even aware that their prescribing activity was tracked, let alone sold, until The New York Times broke the story on May 4, 2006. However, this issue has been percolating at the local level for some time, as concerned physicians lobby their state governments to legislate a solution to what is considered a breach of their professional privacy. Several states have introduced bills to restrict the flow of this type of physician data, including New Hampshire, Arizona and West Virginia, but the bills are not likely to pass in this session.
Although it has not become a federal legislative issue yet, it has gained national attention because of the involvement of the American Medical Association. In addition to marketing activities, the AMA is involved in the sharing of physician data for a variety of reasons, including research, government policy issues, and development of best clinical practices.
Gary Bryant, MD, ACR Board member, commented, “This issue is not well known in the physician community; very few are aware of the data mining done by pharmaceutical companies and the AMA’s role in it. In general, I am opposed to legislative mandates because they usually come with a price tag. We need more information from the AMA about their role and the dollars it receives, and more information on the other areas, like research, that are affected by restrictions.”
All Health Information Organizations are licensees of the AMA Physician Masterfile, and in response to member concerns about physician privacy, the AMA has established a Prescribing Data Restriction Program.
The PDRP is a Web-based service that allows AMA members to restrict the use of their data by preventing it from being shared with pharmaceutical sales representatives, thus protecting their privacy. It allows doctors the option to share their data for research and policy purposes.
Dr. Kent was pleased to see the implementation of the new program, noting, “The PDRP is the equivalent of a ‘do not call list’ for pharmaceutical representatives, with regards to them accessing your prescribing information. It does not restrict the ability of physicians to interact with the representatives for updates on their products.”
Yet some physicians are wary of the impending PDRP program, like Michael Henrickson, MD, also a member of ACR’s CORC. Asked about the new registry, he said, “The AMA PDRP is a compromise solution which will not truly address deep-seated concerns many practicing clinicians have about pharmaceutical companies’ access to their Masterfile prescribing information. ACR members will need to consider if the PDRP program is sufficiently restrictive, or if this program temporarily preempts a legislative solution. Physicians who enroll in PDRP need to know their prescription data will still be accessible to these companies to preserve the AMA’s stated intent of evidence-based research.” s

Beginning July 1, 2006, AMA members can restrict their information using the PDRP system; visit www.ama-assn.org to sign up. The AMA’s position paper on the PDRP and physician prescribing data is available in PDF format via their Web site; you can also review their “Industry Best Practice Guidelines” on the appropriate use of physician prescribing data.