We pay the highest prices for prescription drugs in the world

Just got through reading an NYT article, Dr. Drug Rep, where a doctor recruited by the drug companies slowly realizes their corrupting influence.

It is not news that drug companies send reps to doctors urging them to proscribe their product.

It is not news that these same reps recruit and pay doctors to promote their product to other doctors.

And it should come as no surprise that doctors who take money from Big Pharma are less inclined to speak ill of them or their products.

But this little tidbit struck me as a bit new: doctors who shill for Big Pharma are given detailed dossiers on their attendees so that they can single out lucrative practitioners for extra attention.

A note from another rep reminded me of a scene from “Mission: Impossible.” “Dr. Carlat: Our main target, Dr. , is an internist. He spreads his usage among three antidepressants, Celexa, Zoloft and Paxil, at about 25-30 percent each. He is currently using about 6 percent Effexor XR. Our access is very challenging with lunches six months out.” This doctor’s schedule of lunches was filled with reps from other companies; it would be vital to make our sales visit count.

Naïve as I was, I found myself astonished at the level of detail that drug companies were able to acquire about doctors’ prescribing habits. I asked my reps about it; they told me that they received printouts tracking local doctors’ prescriptions every week. The process is called “prescription data-mining,” in which specialized pharmacy-information companies (like IMS Health and Verispan) buy prescription data from local pharmacies, repackage it, then sell it to pharmaceutical companies.

Got that? Big Pharma gets weekly updates on who prescribes what. Then they can target their marketing efforts and get feedback on what tactics are working with types of doctors, or even specific doctors.

But isn't there some kind of safeguard for this data? I mean, doesn't it seem odd that pharmacies would divulge the prescription habits of a given doctor?

Funnily enough, there is. Pharmacies don't usually release doctor's names with their data.

So, how do they know which doctor prescribes what? Easy, the AMA tells them:

The American Medical Association is also a key player in prescription data-mining. Pharmacies typically will not release doctors’ names to the data-mining companies, but they will release their Drug Enforcement Agency numbers. The A.M.A. licenses its file of U.S. physicians, allowing the data-mining companies to match up D.E.A. numbers to specific physicians. The A.M.A. makes millions in information-leasing money.

Those millions are paid by Big Pharma, and ultimately by you and me.

That's nice.