ON COST CONTROL CHECKLIST - CURB INAPPROPRIATE DRUG MARKETING by John McDonough

Last month, my colleague Brian Rosman was in a part of Manhattan near a major medical center. Passing a local deli, he couldn’t help but notice a large sign in the window – “Drug Reps: Get Your Party Platters Here!”

A new coalition starts today on a key aspect of health care cost control. Health Care For All is joining forces with consumer advocates, non-profit organizations, insurers, and providers to launch the Massachusetts Prescription Reform Coalition (MPRC). We are taking action against pharmaceutical marketing practices that wastefully inflate prescription drug costs.

Why drugs? Cost control is critical to the financial viability of health reform. Controlling inappropriate drug marketing should be a key item on any list of meaningful cost control measures. Prescription drugs are among the most commonly used forms of health care today. Over 72 percent of American households have someone taking a prescription medication. And drug prices continue to rise. The average price for the most widely used brand-name drugs rose nearly 50 percent from 2000 to 2006 – more than twice the rate of inflation.

Pharmaceutical marketing is an obvious place to start. Drug companies invest $7 billion yearly in marketing to physicians.

They give gifts to prescribers and purchase information from our prescriptions to micro-target their messages (called “data-mining”). The cost for these practices is passed to all of us who pay for drugs – consumers, insurers, businesses and government. These tactics drive up prescribing of brand name drugs that are no more safe or effective than lower-priced generics. If you doubt the impact of prescriber marketing, take a look at Dr. Daniel Carlat’s first-hand account of his experiences in Massachusetts with gifts and data-mining in the New York Times Magazine. One of many shockers in that piece – today about 1 in 5 US physicians is acting as a paid agent for a pharmaceutical company.

The state should heed Dr. Carlat’s warning. We should follow the lead of UMass Memorial Medical Center and Boston Medical Center, two local institutions that have recognized the danger of inappropriate marketing and taken voluntary action to sever ties between the industry and their staff. While prescription drug cost control is not a silver bullet, inappropriate drug prescribing is an important part of our cost crisis.

As we attempt to construct “smart” cost controls – controls that eliminate inefficiency and inappropriate activities – it makes sense to curb these practices as part of the solution. We hope Senate President Murray will consider this arena for reform as she constructs her cost control legislative proposals.

John McDonough
Executive Director, Health Care for All