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Consumer Group Opposes California Pharmaceutical Marketing Bill as Invasion of Patient Privacy

By Frank D. Russo

The Consumer Federation of California has sent a stinging letter to the Senate Health Committee opposing SB 1096 (Calderon) as an invasion of patient privacy and interference with the doctor-patient privilege. It is scheduled to be heard by the committee on March 12, one week from today.

Here is the letter:

We regret that the Consumer Federation of California must oppose SB 1096 (Calderon).

This bill raises significant privacy and health care concerns for patients. The bill would allow the sharing of a patient’s confidential medical information regarding prescription drugs among a pharmacy, third party corporations and pharmaceutical companies.

SB 1096 would create an exception to California’s Medical Information Act, and allow sharing of confidential patient drug prescription information without a patient’s consent. The bill’s main backer, Adheris Inc., is a subsidiary of inVentiv Health Inc., a drug marketing company. Under SB 1096, drug stores would provide confidential patient prescription information to third party businesses. The third party would prepare mailings to patients that would have the appearance of coming from the pharmacy. These third party marketing corporations would, in turn provide patient information to, and receive payment from, pharmaceutical drug manufacturers to send the mailings, ostensibly to remind patients to take their medications or to renew their prescriptions.

This type of privacy invasion should not occur without the consent of the patient. Under California law, pharmacists counsel patients on prescription drugs at the point of purchase. It would be a simple matter for the pharmacist to ask the patient if he or she wants to opt in to receive reminder notices as part of the counseling.

Drug companies are interested in acquiring every bit of personally identifiable information about patients in order to market their products directly to patients. The bill does not require the third party mailer to remove or encrypt personally identifiable patient information that it shares with the pharmaceutical company.

SB 1096 states that these mailings to patients should be written to ill-defined “evidence based or consensus based practice guidelines” and it specifically identifies patient self-management strategies as a goal of these mailings. The drug companies that write these mailings determine what constitutes a consensus for medical practices, and drug companies define the terms of patient self- management.

This is a significant intervention by drug companies into the physician – patient relationship. We believe a patient’s doctor is the best source for informing a patient about how to manage his or her health condition.

The bill would allow a third party to send reminder mailings that may be in direct contradiction to a physician’s recommended course of treatment. For example, if a patient begins to take a medication and experiences an adverse reaction, the patient might discuss the problem with the prescribing physician, and an alternative course of treatment may be developed. Unaware of this change in treatment, the pharmacy has communicated to the third party mailer that a patient is receiving a medication. The drug company that manufactures the medication then prepares mailings to remind the patient to take his or her medication, and to renew the prescription.

These mailings are designed to look as if they came from the pharmacy. The patient is now receiving contradictory instructions from two trusted sources, the doctor and the pharmacy. Senior citizens have the highest incidence of prescription drug use, and some may be confused by these conflicting directives. This kind of direct interference in the doctor - patient relationship is potentially dangerous to patient health. Yet the bill does not include any penalties for drug companies that engage through intermediaries in these communications with patients in contradiction to a doctor’s recommended course of treatment.

SB 1096 intrudes on patient privacy and it interferes with the doctor - patient relationship.
We respectfully ask the members of the Senate Judiciary Committee to vote No on SB 1096.

Posted on March 05, 2008

Comments

I object to this bill and feel it is an attempt to weaken existing California privacy legislation. I agree that it interferes with the relationship between the doctor and patient and can lead to confusion if the literature appears to conflict with the doctor's orders. I feel this bill is wholly unnecessary and should be stopped before it compromises patients' privacy.

Posted by: Donald Wallace at June 8, 2008 01:24 AM

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