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Prying Eyes at the Pharmacy

 

>

> DRUG STORE COWBOYS

> Dan Frosch, AlterNet

> Pharmacies and drug companies have come up with a novel way

> to make more money -- use our medical records to

> pitch us more drugs.

> http://www.alternet.org/drugreporter/20512/

>

> Drug Store Cowboys

> By Dan Frosch, AlterNet. Posted November 16, 2004.

>

> Pharmacies and drug companies have come up with a novel way to make

> more money – use our medical records to pitch us more drugs.

>

>

> A pharmaceutical company gets sued for bribing doctors to promote a

> particular drug. An HIV-positive New Yorker sues a drug store chain for

> buying and entering his medical records in a database without his

> consent.

> Two companies get sued for sending out unsolicited free samples of

> prescription drugs like Prozac. And on and on.

>

> Manufacturing legal drugs is a growth industry and the latest twist in

> the

> multi-billion dollar drug-pushing game is that your local pharmacy may be

> turning into a marketing agency for the big drug companies.

>

> The Privacy Rights Clearinghouse (PRC), a consumer advocacy group,

> filed a

> lawsuit in September against supermarket giant Albertsons in California

> Superior Court, for allegedly selling the private prescription drug

> information

> of its customers to pharmaceutical companies. PRC also named 17

> pharmaceutical heavyweights, like AstraZeneca, Eli Lilly and

> GlaxoSmithKline,

> as co-defendants, claiming that the companies use the information to

> promote their drugs through unsolicited phone calls and letters.

>

> According to PRC, the drug companies have been paying Albertsons between

> $3.00 and $4.50 for every promotional letter written and between

> $12.00 and

> $15.00 for every phone call made to unwitting customers. Albertsons, the

> group maintains, stands to make millions in the process. PRC says both

> Albertsons and the drug companies are breaking California law because

> customers are never given the option of signing up to receive the

> calls or

> letters as mandated by the state's privacy regulations.

>

> " What Albertsons is doing interferes with the patient-physician

> relationship

> and it visits terrible harm on people who rely on prescription drug

> notices and

> don't realize that they're being paid for by drug companies, " says

> Jeffrey

> Krinsk, an attorney for PRC. " Perhaps most pernicious is the potential

> harm of

> third parties learning the existence of an underlying condition if the

> mail is

> mistakenly sent to the wrong address. "

>

> The drug companies footing the bill are equally culpable, adds Beth

> Givens,

> director of PRC. Though the actual letters and phone calls may come from

> Albertsons and appear to inform patients of the benefits of a

> particular drug

> or remind them to refill a prescription, the drug companies are clearly

> involved. A form letter and a training phone call transcript from

> Albertsons,

> provided by PRC, include clauses stating that the letter or phone call

> was

> " provided with financial support " or " sponsored by " a particular drug

> company, but that no information would be shared.

>

> That, says Givens, is proof enough that information has indeed been

> exchanged between Albertsons and the drug companies, especially given the

> potential money both parties can make in the process. Further, Givens

> alleges that the refill reminders Albertsons sends on behalf of the drug

> companies are sometimes to customers whose doctors have not actually

> authorized a refill – a frightening charge.

>

> Says Givens: " Albertsons wouldn't have any drug marketing program unless

> willing pharmaceutical companies signed on the dotted line. "

>

> Indeed, it's the ostensibly cozy relationship between pharmacies and drug

> companies that's raising eyebrows in this particular case.

> Prescription drug

> costs have risen sharply over the past decade – up an average of 7.3

> percent

> annually from 1992 to 2002, according to the Kaiser Family Foundation, a

> non-profit health research organization. During that same time, the

> foundation reports, the number of prescription drugs purchased by

> Americans

> exploded by 74 percent. Subsequently, pharmaceutical companies have

> become the beneficiaries of a $400 billion a year business – more than

> enough incentive to keep their marketing machines running full steam.

>

> Drug companies spend billons each year promoting their wares, in the

> form of

> television and print ads, as well as giveaways to physicians. A 2001

> lawsuit

> against TAP Pharmaceuticals for bribing doctors to promote Livapro, a

> prostate cancer drug, has led to increased scrutiny, but the drug

> companies

> have invariably refined their techniques. The alleged backdoor scheme

> highlighted in the PRC suit seems to indicate a more nuanced marketing

> approach.

>

> " Albertsons is acting as a vehicle for the drug companies, " says Meredith

> Rosenthal, assistant professor of health economics and policy at Harvard

> University. " There have always been very worrisome ethical

> implications on

> the physician side in terms of pharmaceutical companies paying

> doctors, and

> I think this is similar in that consumers trust their pharmacies to be

> their

> unbiased advocate. "

>

> There is some precedent to what's happening in California. In 2001, two

> Massachusetts men, also represented by Jeffrey Krinsk, sued CVS

> Pharmacy, Glaxo Wellcome pharmaceuticals and Elensys, a marketing

> company, for mailing out promotional drug information based on a

> patient's

> particular condition. CVS agreed to stop the practice.

>

> Similar suits have been filed over the past few years against local

> pharmacies

> and drug companies in other states as well. In 2001, an HIV-positive New

> York man sued CVS for buying his medical records and allegedly logging

> them into a database without his consent after it took over operations

> of his

> local pharmacy. In 2002, the Clearwater, Fla.-based Eckerd pharmacy chain

> paid $1 million in legal fines for using the medical information of

> its customers

> for marketing purposes. That same year in Florida, Walgreens and Eli

> Lilly

> were sued for sending out unsolicited, free samples of prescription

> drugs like

> the anti-depressant Prozac.

>

> Lawyers like Krinsk are filing claims state by state because the

> federal Health

> Insurance Portability and Accountability Act (HIPAA) of 1996, while

> giving

> patients control over medical records, doesn't completely protect their

> prescription drug information. What's more, many states have privacy laws

> which go beyond HIPAA and actually prohibit using medical information for

> marketing without first getting consent from the patient. California,

> as it

> happens, passed such a law in 2002.

>

> Daniel Solove, a professor at George Washington University law school and

> an expert in privacy law, called the letters and phone calls from

> Albertsons

> legally " deceptive " because patients think they're from the pharmacist

> when

> really, it's the drug companies speaking. Solove referred to one

> letter from

> Albertsons which warns customers to renew their prescription of Plavix, a

> heart disease medicine, as " scare tactics. "

>

> " The letter basically implies that you're at an increased risk for a

> heart attack

> if you don't keep taking this drug, " he says. Solove adds that if

> customers

> have not given their permission to Albertsons first, then both

> Albertsons and

> the drug companies are in violation of California privacy law. " There

> are some

> big problems with this kind of marketing, " he says.

>

> For their part, the pharmacies and the drug companies deny any

> wrongdoing.

> Albertsons spokeswoman Stacia Levenfeld emailed AlterNet a statement

> released by the company after the lawsuit was originally filed: " We

> highly

> value and respect the privacy of our pharmacy customers and do not

> sell, nor

> have we ever sold, their private information. We consider the

> allegations in

> this complaint to be false and totally without merit – and we will

> vigorously

> defend ourselves against them. "

>

> Albertsons operates 2,000 pharmacies in 37 states, including Osco,

> Jewel-Osco and Sav-On Drug Stores.

>

> As for the drug companies, AstraZeneca spokeswoman Rachel Bloom says:

> " It is our policy not to comment on ongoing litigation. However, in

> the matter

> you are referring to, we will defend ourselves vigorously. "

>

> (Incidentally, on Oct. 18, the AFL-CIO and two consumer groups filed suit

> against AstraZeneca for misleading patients into switching to a more

> expensive ulcer medication through a promotional campaign.)

>

> Eli Lilly spokesman Phil Belt also declined to comment directly on the

> lawsuit.

> " We obviously feel very good about our privacy policy, " he said.

> " We've got a

> privacy officer dedicated to making sure systems are in place that

> respect

> patient and customer privacy. "

>

> GlaxoSmithKline did not return repeated phone calls from AlterNet.

>

> Jeffrey Krinsk says he's considering expanding the lawsuit to include

> other

> drug companies and pharmacies he believes also engage in illegal

> marketing.

> Regardless of the outcome, it's become disturbingly clear that in the

> astoundingly lucrative and increasingly cutthroat world of

> prescription drugs,

> people's personal medical information is being bought and sold without

> their

> knowledge.

>

> Says Larry Sasich, a pharmacist of 20 years and a research analyst for

> Public

> Citizen, a consumer advocacy group in Washington D.C.: " This is a

> reprehensible practice. The fact that you are using confidential medical

> information to a very real extent and that you're promoting expensive

> drugs to

> a patient that they might not need ... It's unethical professional

> behavior. "

>

>

>

> Dan Frosch is a New York-based journalist whose work has appeared in the

> Los Angeles Times, The Source and the Santa Fe Reporter.

>

>

>

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