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Prescription Data Mining - New Hampshire and Vermont Lead in Prohibiting

Dan Carlat writes an excellent blog - The Carlat Psychiatry Blog, which supports the search for honesty in medical education. It should be required reading for medical school deans, full- and part-time.

The blog could also be read with profit by executive vice-deans, vice deans for clinical affairs, vice deans for research, vice deans for education, associate deans for faculty affairs, and even associate vice presidents for new models of medical education. Especially the latter.

From a recent post:

Prescription data-mining is a marketing tool in which drug companies purchase information from pharmacies that allow them to spy on doctors' prescribing practices. The companies use this information in a variety of sneaky ways. Front line drug reps download this information to their laptops and use it to tailor their marketing pitches before they call on doctors. Higher level marketing executives use the data to craft targeted marketing campaigns involving everything from pseudo-journals to invitations to promotional dinner meetings.

It is a deceptive and quite nauseating marketing practice,
but it has continued through the years because it seemed for a while that everybody stood to win. Drug companies got invaluable demographic information in order to sell the newest and most expensive drugs. Data-mining firms; like IMS, built their entire lucrative business model on their new identities as information brokers; pharmacies reaped profits by selling prescription info to IMS and their ilk; the American Medical Association profits to the tune of several million per year by whoring out the organization and selling doctors' DEA numbers to data base firms; and finally, individual doctors in their offices started receiving dozens of invitations to fancy dinners by reps who wanted them to prescribe more of their drug.

But now this corrupt house of cards is tumbling down. Not all at once, but gradually, state by state, appeals court by appeals court.

Here are a couple of recent developments.

1. New Hampshire. In 2006, New Hampshire's legislature banned data-mining. In 2007, lawyers were able to convince a district court to strike down the New Hampshire law by arguing that buying and selling prescription information was protected by free speech safeguards. In 2008, the First Circuit Court of Appeals overturned the district court's decision, and unanimously upheld New Hampshire's Prescription Confidentiality Act. The forces of greed do not give up easily, and the data-firm lawyers submitted their case to the United States Supreme Court. Well, a few days ago, the Supreme Court declined to consider the case, sending a message to many other states that the ban on data-mining is, in fact, constitutional.

2. Vermont. In 2008, the Vermont legislature passed a law banning prescription data-mining unless physicians specifically opt in to their data being bought and sold. Data firm lawyers descended on the Green Mountain State, and submitted an appeal to the federal Second Circuit Court of Appeals requesting that they grant an injunction blocking the implementation of Vermont's law. Twas not to be. The Appeals courts just refused to block the law.


There is a strange situation in Minnesota where DNA data of newborns, acquired by the state, ended up in a study in Finland. Perhaps the state legislature should look into medical and prescription data mining practices and take appropriate action?

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