Prescription Data Mining: What it Means for Primary-Care Physicians

June 28, 2011

Pharmaceutical companies cheered as the U.S. Supreme Court recently overturned a Vermont law banning data mining for prescription drug marketing purposes. Many physicians, however, did not share similar celebratory feelings.

Pharmaceutical companies cheered as the U.S. Supreme Court recently overturned a Vermont law banning data mining for prescription drug marketing purposes. Many physicians, however, did not share similar celebratory feelings.

A key element of the Vermont law prohibited the sale or use of a physician’s prescription records for marketing purposes - without that physician's consent. Overturning the law, for many physicians in the state, seems like a slippery slope into privacy violations, and worse, patient confidentiality breaches.

The Supreme Court determined the law violated the First Amendment by infringing on commercial free-speech rights. Though Vermont was one of only three states in the country with such a law against data mining, it has shed a light on a policy influencing primary-care providers nationwide.

Here’s how data mining works: After receiving prescription records from physicians, pharmacies remove patient identifying information from the records. Health information organizations (data miners) then buy the records and analyze them to determine the most suitable doctors pharmaceutical companies should market to - this is called detailing. Prescription drug companies then purchase this information and use it for physician-tailored marketing strategies and incentives.

A recent poll conducted by MDLinx found that 81 percent of physicians said “no” when asked if they would proactively "opt in" to a system which would collect their prescribing records. When asked if they considered the collection of their prescribing history a violation of their privacy, 65.3 percent answered “yes.”

Though the patient record information is sold without identifying patient information, many are asking, what if a mistake is made? If data is not adequately protected, it raises all types of red flags when patient-physician confidentiality comes into play. And, if a physician is practicing in a particularly rural area, even if the patients name is removed, he may be easily identifiable.

The court case also sheds light on something that may be affecting day-to-day decision making of primary-care providers. If a physician is profiled as a certain type of prescriber, pharmaceutical companies may be tailoring their salesmen to cater to that provider’s needs. Physicians need to be sure to keep informed of all their options - not just the options salesmen think will appeal to them.

Other healthcare organizations, patients, and advocates are voicing other concerns. According to The Pew Prescription Project, an organization aimed at advancing pharmaceutical policy, data mining can negatively influence public health, encourage the prescription of expensive brand-name drugs over generics, and decrease physician-patient privacy.

Pharmaceutical and data mining companies, however, heavily disagree with those concerns - and they make good points. According to IMS Health, a data mining company and challenger of the Vermont law, data mining plays a role in expanding research, contributing to the study of prescribing trends, the monitoring of the safety of new medicines, and the assessment of treatment variability.

“Transparency is vitally important to advancing healthcare. The availability of information on the prescribing practices of physicians enables communications about new medicines, best practices and safety updates,” IMS Health Senior Vice President and General Counsel Harvey Ashman said in a statement, “This information is essential to improved patient care and safety.”

For now, physicians have to face the possibility that their prescription record information is probably being sold, and, if they don’t stay informed and aware, it is probably being used to help determine their future prescription orders.

But there is a loophole. In 2006, the AMA initiated the Physician Data Restriction Program, an “opt out” option when it comes to data mining. When a doctor “opts out,” his prescription data is available only for academic and government research. 

“While the AMA supports the appropriate disclosure of prescriber data, the AMA firmly believes that every physician has the unequivocal right to decide whether his or her individual prescribing data is shielded from pharmaceutical detailers,” the AMA said in a statement.

Maine and New Hampshire are the only two states remaining with laws restricting prescription data mining.