Healthy Skepticism Library item: 15064

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Ho V.
Bill would make prescription data private
seattlepi.com 2009 Jan 23
http://blog.seattlepi.nwsource.com/healthreport/archives/160219.asp

Full text:

Many patients assume their prescription history is confidential, but a loophole in a federal privacy law is letting pharmaceutical marketing companies to contact consumers with targeted, promotional campaigns.

It goes like this: You’re about to run out of your medication, when you get a friendly call or letter reminding you to refill your prescription. But the reminder soon becomes a pitch encouraging you to try a new, often costlier medication.

“(The letters and e-mails) are couched as being of service to the patient, but in reality they’re marketing newer, more expensive drugs, without the patient’s doctor having any idea that this marketing pitch is being done,” said Rupin Thakkar, a pediatrician in Edmonds and co-chairman of the Washington Coalition for Prescribing Integrity.

To fight this, Rep. Jamie Pedersen (D-Seattle) and others have introduced House Bill 1493 to close the loophole. Advocates say the change would protect thousands of patients at no cost to taxpayers.

“It creates a lot of confusion,” Thakkar said. “When these phone calls come in, patients assume – rightfully – that their prescriptions are private. They assume this message must be coming from their doctor or pharmacist.”

Because health-care providers are not part of the tactics, the potential for danger is great, he said. One Seattle woman who used the generic version of Allegra recently received a letter (with coupons) suggesting that she try Allegra-D, which contains pseudoephedrine, a drug that interferes with one of her health conditions.

Another woman in Bellingham got a call at home from a prescription benefits manager – another type of loophole exploiter – encouraging her to switch to a generic, less expensive form of her medication.

When the woman called her doctor, the doctor advised against the switch, saying the generic brand would not adequately treat her symptoms, advocates said.

Doctors worry most about patients with chronic conditions, who often need to take a lot of meds, making them more vulnerable to drug-switching campaigns.

Thakkar said the companies are exploiting a 2003 loophole in the HIPAA, the Health Insurance Portability and Accountability Act.

Previously, the law specified people who could share patient information, such as pharmacists, doctors, and insurance agents.

But the Bush administration added the vaguely coined “business associates” to that group, with the caveat that the shared info had to relate to “patient care.” To fulfill that obligation, the “associates” simply include a reminder to refill a prescription.

“The sharing of prescription information for marketing purposes without consent violates the spirit of privacy law, and destroys the confidentiality of the doctor-patient relationship,” said Leigh Sims, a spokeswoman for the coalition behind the bill.

HIPAA allows states to pass stronger privacy protections. To survive, House Bill 1493 must pass out of committee by Feb. 8.