Drug Marketing and Data Mining: Free Speech or Free Ride?

Drug reps come to our office fairly regularly, but not as often as they used to. Some of them look like regular folks, but many still look a lot like Barbie and Ken. These guys have a tough job. It’s hard to cultivate relationships when you can’t pay off physicians with free trips or offers of remuneration for serving as a ‘consultant’. Remember ‘dine and dash’?

Drug reps come to our office fairly regularly, but not as often as they used to. Some of them look like regular folks, but many still look a lot like Barbie and Ken. These guys have a tough job. It’s hard to cultivate relationships when you can’t pay off physicians with free trips or offers of remuneration for serving as a ‘consultant’. Remember ‘dine and dash’?

Despite these prior excesses, I do not disparage pharm reps, many of whom are ethical professionals who have developed vertical knowledge on a narrow niche of medicine. I have learned from them, but I remember that they are salesmen. Caveat emptor.

Drug reps face other challenges beyond the ban on ballgame and theater tickets. We physicians are often constrained by insurance company formularies that dictate what we can prescribe. The insurance companies would balk at that statement and would offer a lawyerly response that, of course, we physicians can prescribe any drug that we believe best serves the patient’s medical interest, but that this selection may not be a covered benefit. Get the idea?

One tool that pharmaceutical companies have relied on for years is to purchase individual physician’s prescription data from pharmacies. This data mining gives pharmaceutical companies lists of physicians by name and the drugs prescribed by each doctor. In other words, the Nexium rep can learn how much or how little of the drug I prescribe compared to its competitors. (No patient identifying data is included.) Drug reps can be given sales goals based on this data.

Kirsch is prescribing too much Prevacid, which is giving the corporate folks heartburn. More aggressive sales techniques required. Launch OperationBURYPREV ASAP.

Physicians have always hated this open secret in the pharmaceutical industry. It’s open because we all know it is practiced and it’s secret because drug folks won’t talk about it. Doctors, test this the next time a drug rep wanders into your office. Use the following ice breaker as a guide.

“Yo Rep, can I see my individual prescribing data that your company has mined on me?”

At that moment, you will be amazed at the stillness of the lips and larynx that are facing you. An orifice that is usually a portal for endless chatter becomes a hollow cavern. It’s almost a miracle.

The Supreme Court ruled in a 6-3 vote at the end of their term last year that data mining by pharmaceutical companies is constitutional. Vermont had previously passed a law restricting this practice, which the Court has struck down.

I respect the decision because the Supreme Court’s responsibility is to determine if an action is legal, not to make policy. The court did so to protect free speech. Drug reps, however, won’t be speaking freely on this to physicians. Wonder how they and their bosses would feel if we mined their data. Would they agree that free speech goes both ways?