The AMA and the data-mining of prescription records
Another interesting New York Times article, entitled Doctors Object to Gathering of Drug Data by Stephanie Saul in the Thursday May 4th 2006 edition.
It is an interesting example of what I call the “soft corruption” that is evident all across US society, business, and government.
A group of data-mining companies (the article mentions IMS Health, Verispan, Dendrite International, and Wolters Kluwer) pay various retail drugstore chains (e.g. Walgreens and CVS) to provide them with electronic data on each prescription they handle. This data would include the prescribing doctor’s name and the details of the drug prescribed.
The data-mining companies then match up this data with dossiers on each doctor provided to them by the American Medical Association. The data provided in what the AMA calls the Masterfile includes the doctor’s specialty, board certification, and disciplinary records. The AMA did not disclose to the NYT reporters how much they get paid for this information but did state that the AMA’s total revenue from the sale of information was $40 million per year.
The AMA is opposing any attempts to restrict access to this data in spite of the fact that, according the NYT article:
A Gallup Poll commissioned by the A.M.A. in 2004 found that two-thirds of doctors surveyed were opposed to the release of such data to pharmaceutical representatives, and that 77 percent felt that an opt-out program would alleviate concerns about the release of data. Nearly a quarter of the doctors were not even aware that the pharmaceutical industry had access to such information.
The data-mining companies (IMS Health, Verispan, Dendrite International, and Wolters Kluwer) match up the prescription records with doctors’ dossier’s provided by the AMA and then sell that information to the pharmaceutical companies for use by the industry’s 90,000 salesmen.
And what do the salesmen do with this information? They can use it to reward doctors who frequently prescribe their drugs with various “perks” including gifts, and meals. It also allows them to target what the industry calls “cowboys”, doctors who are willing to prescribe a drug as soon as it comes on the market.
The “soft corruption” in this case is exhibited by the AMA which is behaving against the wishes of two thirds of its own members because it does not want to lose millions of dollars in revenue. (And, it would appear, selling information about its own members without their knowledge or approval.)
You also have an entire industry (the article states that IMS Health’s annual revenue last year was $1.75 billion, presumably their competitors’ revenues are on a similar scale) based on facilitating the ability of the pharmaceutical industry to corruptly influence doctors to prescribe drugs against their patients’ interests.
And I am not sure we should let the retail drugstore chains off the hook, either. They are selling information about what each doctor prescribes without getting permission from the doctors.
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