The wrong prescription for cutting health costs
By Senator Richard T. Moore
July 9, 2012 ... "Drug maker to pay $35 million to state," was the heading of an article published in the Boston Globe's July 3, 2012 edition. The story was about "the largest health care fraud case in United States history," according to Deputy U.S. Attorney General James M. Cole. The case concerned an agreement by pharma-giant GlaxoSmithKline to pay the federal government and states, including Massachusetts, for illegally promoting and marketing its anti-depressant drugs Paxil and Wellbutrin between 1998 and 2003.
According to the Globe, "the company paid millions of dollars to doctors to speak at and attend meetings, sometimes at resorts, at which the off-label uses (of the drugs) were encouraged. As U.S. Attorney Carmen Ortiz of Massachusetts stated, "This case demonstrates our continuing commitment to ensuring that the messages provided by drug manufacturers to physicians and patients are true and accurate and that decisions as to what drugs are prescribed to sick patients are based on best medical judgments, not false and misleading claims or improper financial inducements."
"The drug industry spends an annual $8,000-$13,000 per physician on promotions... Marketing expenses constitute a prime reason for the high cost of prescription drugs," wrote Carl Elliott of the University of Minnesota's Center for Bioethics in a 2004 journal article. This marketing expense has certainly increased in the last eight years. David Tian, a representative of the American Medical Student Association's PharmaFree Campaign, referred to the meals as "wining and dining," comparing them to "bribes."
Most seniors or others with high cost drug needs would never seriously think of dining at a restaurant with three or four "$" signs in its rating. Yet, those high drug costs paid by patients and their insurance plans, as well as taxpayers, allow drug companies to lavishly entertain doctors at those same expensive restaurants.
In 2008, the Massachusetts Legislature passed the Prescription Drug and Medical Device Gift Ban to try to put a stop to these outrageous practices of the drug and medical device industries and to try to address the rising cost of health care. Since that time, all four medical schools in Massachusetts have also adopted strong ethics policies to reduce the potential for such ethical conflicts by their faculties.
Even today, the Governor and the Legislature are working on comprehensive legislation to improve health care quality and contain the rising cost of care. The likelihood of taming those costs will, in part, depend on reining in the growth of drug costs and addressing the waste and misuse of prescription medications. No one can honestly claim to be fighting to reduce the high cost of health care while supporting legislation weakening the corrupting influence of pharmaceutical marketing to physicians.
It is especially ironic and unsettling, then, that the budget that the Legislature just sent to Governor Patrick contained provisions that weaken the prescription drug gift ban law, put in place to help protect consumers against spiraling health care costs - in particular, rising prescription prices. As AARP - Massachusetts wrote to the Governor last week, "Consumers should not have to foot the bill when drug companies wine and dine doctors at restaurants across the Bay State - especially when prescription drug spending continues to be the fastest growing medical expenditure for consumers, and drug prices continue to climb. Prescribing decisions are too important to be tainted by marketing practices."
If the Governor were truly serious about addressing rising health care costs, he would have vetoed the sections that create new loopholes in what had been among the strongest prescription drug ethics rules in the country. Health care costs cannot be controlled by taking the side of special interests rather than protecting the public interest. Given the widespread support in the House for weakening the prescription drug gift ban law and the Governor's desire to please the pharmaceutical and biologics industries, taxpayers and consumers should brace themselves for continued assaults on their pocket books by the drug industry.