Drug companies -- such as GlaxoSmithKline -- have chosen to publicly oppose the good idea, and to ignore the bad idea.
The Massachusetts proposal is the good idea, and the Senate idea is the bad one. Here's why: All that's being required in Massachusetts is that a public record be made of the gifts drug companies give to doctors. There is a thin line between a gift and a bribe, and there is a public health interest in knowing which doctors in which specialties have received gifts as they write their prescriptions.
- Massachusetts is enacting legislation that would require all drug company gifts to doctors greater than $50 to be made public; the measure is a watered-down version of a bill that initially opposed all gifts to Bay State docs.
- The U.S. Senate is considering a bill that would create a national "academic detailing" system, in which independent non-profit "reps" would counter drug company sales forces by telling doctors about generic medicines, step therapies, and other alternatives to new, pricey, branded drugs.
The Senate's idea (co-authored by Democratic senators Herb Kohl, Dick Durbin, Ted Kennedy and Bob Casey) is the bad one. The reason for that is that the government is unlikely to be as good at detailing as the 90,000 or so drug reps currently wielded by the drug companies. Remember, drug reps are driven by supply and demand, receive incentive bonuses for meeting prescription goals, and know their products inside out. The government force, by contrast, would be driven by policy goals -- noble ideals, to be sure, but they can only hope to occasionally be on target.
The bill's sponsors point out that studies have shown than every dollar spent on counter-detailing produces two dollars in saved prescription costs. But unless those savings can be leveraged into some kind of bonus system for individual counter-detailers it will pale against the kind of cash incentives that drug reps get when they meet their prescription goals.
Despite these flaws in the Senate effort, the drug companies have gone to bat against the Massachusetts bill. GSK's Christopher A. Viehbacher, president of U.S. pharmaceuticals, sent a letter to Massachusetts governor Deval Patrick in May warning him not to "devalue those assets" that make GSK want to work in the state. He accused Massachusetts pols of having a "strong anti-biopharmaceutical streak." Now, according to the Boston Globe, Big Pharma has stepped up the pressure, launching an army of lobbyists, all intent on keeping concealed the gifts that drug companies give to doctors.
Perhaps they think the Senate bill will fail on its own merits, whereas better ideas -- like the one in Massachusetts -- need more concerted action to kill.