When I was working on behalf of hospitals and other care providers, I spent a lot of time pouring over the details of contracts associated with IT vendors (Cerner, Siemens, GE Medical, Meditech, Epic, etc.). In the early 90's I noticed a new trend - a clause allowing the IT vendor to sell prescription data, patient identifiers removed. When I pushed back I was surprised at how important this was to the vendor. Their postition seemed to be "forget removing the clause, let's talk about other concessions instead?" What could this mean? Only one thing: The vendors were getting paid good money for this data.
Next question: Why?
Let's start with the myth that this is somehow going to make personal medical information known to corporations who may abuse their access. In my experience the data mining of prescription records by pharma never included patient identifier information. Could patients possibly be identified and that information shared with employers? Sure.
But if you're worried about employers getting access to your health records, this is not your major threat.
The claims that your provider submits include all your identifier information, every procedure you had, every med prescribed, your diagnosis and additonal information about your condition and treatment. And guess who receives that claim - your insurance company who is likely a "partner" with your employer. In many cases they have the right to examine your medical record. Remember that HIPAA clause about releasing information needed to support your claim? You signed that before you got treatment.
But I'm on Medicare or Medicaid, you say. My claim is paid by the government. Too bad, these programs outsourced claims processing to BIG INSURANCE (Blue Cross in many States). They have your data. So do a handful of other processing services.
Are they bound to protect this data and not use it improperly. Yes. But as James Madison said, "If all men were angels, we wouldn't need government".
So what is the downside to Big Pharma mining this data? Simple: Bad medicine.
Essentially they're looking for potential markets for their products. If none of the eleven doctors at your clinic prescribe product X for condition Y, then let's get our eye candy in there with lunch, toys and anything else that will make these doctors see the benefits of prescribing our product.
Sorry, did I say "eye candy"? I didn't mean to offend anyone working in pharmaceutical marketing, but my observations over 30+ years shows that at least one of these marketing reps is ALWAYS an attractive female. ALWAYS. (I notice these things.) Lunch is first class too.
There's been more of a crackdown on this type behavior, but the practice continues. Physicians (and their familes) are enticed to "educational conferences" that are mere product pitches. Palm Springs would be a ghost town without these "conferences".
Your physician should be prescribing based on "evidence-based medicine", that is to say, therapies and treatments that have been proven to work, not what is simply well-marketed.
Another widely-used practice is for clinics to have a small pharmacy inhouse, and fill prescriptions right there before the patient leaves. Convenient for the patient. Also profitable for the doctor, who gets a small commission on each sale, unlike prescriptions filled elsewhere. Hey! The more prescriptions I write, the more money I make, even if the patient doesn't need the med! Quick, more script pads!!!
If we had a Medicare for All, and Medicare purchased the meds, the temptation for physicians to prescribe for other than the best reasons would be eliminated. Just one more problem with the for-profit health insurance model.
Here's a timely article on the topic...
http://www.jsonline.com/watchdog/pi/124524374.htmlSorry about the delay in posting, I wanted to have enough time to write something cogent.
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