News Senators on Drugs
posted by February 22 at 13:27 PMon
I’m a fan of public-disclosure laws.
This morning, for example, public-disclosure laws allowed me to learn that just about every pharmaceutical company on the planet—GlaxoSmithKline, Pfizer, Schering-Plough, Eli Lilly, Novartis, and Merck—contributed big money to state Senator Cheryl Pflug (R-5, Maple Valley) during her 2004 campaign. (At the bottom of this post I list the contributions I found.)
I looked this up because earlier this morning, in the senate health-care committee hearing, Senator Pflug was openly antagonistic and dismissive to Senator Jeanne Kohl-Welles’s (D-36, Seattle) no-brainer bill mandating that pharmaceutical companies publicly disclose any gifts made to health-care providers.
Meanwhile, committee chair Senator Karen Keiser (D-33, Kent), who supported the bill, was equally dismissive of Senator Pflug, reminding Pflug to ask questions rather than give speeches.
Pflug lectured the committee that as a nurse she couldn’t see how this bill was helpful to the patient, that she’d never seen gifts influence prescription practices, and that the bill wasn’t a “value add” but rather was a “negative add” for implying that something inappropriate was going on just because the industry spends billions annually on building brand loyalty by marketing directly to doctors.
“I’m concerned about the implication,” Pflug said, “that there is a cause and effect here that is inappropriate.” She wanted to know where the incriminating proof was. “There’s no way to track the impact of marketing on prescriptions,” she said.
Which prompted Senator Keiser to state the obvious: “Well, maybe if we passed this disclosure bill…”
Indeed, as Senator Kohl-Welles pointed out in her testimony, the bill would not prohibit drug companies from fellating health-care providers with free meals, exotic trips, and tchotchkes like free pens—it would simply make it public. (The bill sets up a website where patients could look up gifts by health-care provider and drug company.)
Senator Kohl-Welles also made the compelling point that drugs are the fastest growing component of ballooning health-care costs overall, while marketing (not R&D) is the biggest expense for drug companies. So, putting the spotlight on excessive marketing (which may act as a deterrent for such crass behavior) would help slow health-care costs in general: a bipartisan goal.
In addition to Pflug, PHARMA lobbyist Jeff Gombosky spoke against the bill. Gombosky had two points:
1) The disclosure rules would compromise proprietary information, and
2) Companies already disclose.
Senator Kohl-Welles asked him the obvious question: If the industry is already disclosing, aren’t they already revealing proprietary information.
Answer: Well, the industry discloses advertising information in aggregate. In other words, there’s no mechanism—like the one laid out in Senator Kohl-Welles’s bill—that allows patients to zoom in on health-care providers and drug companies in specific.
After the hearing, I asked Gombosky if that was right. He told me it was. Okay. So, the companies don’t already disclose.
I also asked him what type of proprietary information would be put at risk by disclosing gifts to health-care providers. He simply said: “Everybody’s business plan.”
Hyping her case for simple disclosure, Senator Kohl-Welles made the analogy to public-disclosure laws that govern people like herself and Gombosky. That is: The public knows who’s spending what and on whom to influence public policy. Kohl-Welles reasoned that health-care costs are such a pressing public-policy issue and public-health issue, that the public should know what’s going on behind the scenes.
Senator Pflug objected to the analogy: “I see a benefit [to disclosing] what us and lobbyists are doing,” she said. “[But] I’m quite sure as a registered nurse that I can’t think of any time when gifts affected prescriptions.”
Given her contributors list — GlaxoSmithKline ($675), GlaxoSmithKline (another $625), Pfizer ($675), Pfizer (another $625), Schering Plough ($675), Eli Lilly ($250), Eli Lilly (another $250), Eli Lilly (another $500), Novartis ($500), and Merck ($500)— I took Senator Pflug’s naiveté with grain of salt.