The Business Council of New York State opposes this bill, which would add a new section to the General Business Law to require an opt-in consent from a physician prescriber to authorize the use of prescription data.
The bill's sponsor indicates that prescription drug costs are the fastest growing component of health care spending in the United States and asserts that “prescription drug marketing has exacerbated this problem through an educational sales tactic which …fuels spiraling health care costs.” It is asserted that passage of this bill would help to contain the cost of health care, particularly publicly funded programs such as Medicaid and Child Health Plus. No data is provided to support the cause and effect advanced in this bill, and, while it is widely acknowledged that health care costs have increased, it is not clear that the cost increases are attributable to pharmaceutical companies' communication with health care providers about how to use medicines safely and effectively.
Federal law, the Health Insurance Portability and Accountability Act of 1996, already bars any unauthorized use of patient identifiable information and thus prescriber data cannot include this information. There is a long established role for using specific prescribing data – not identifiable individual patient data – to address patient safety concerns and to meet federally required drug programs that help safeguard patients. Access to prescriber data is necessary to train providers and to comply with FDA required Risk Evaluation & Mitigation Strategies for certain high risk medicines.
Finally, the AMA provides physicians with an opt-out mechanism to prohibit the release of their prescribing data to pharmaceutical sales representatives and although the bill's sponsor believes this is an ineffective solution because most physicians are unaware of its existence, the more immediate way to impact national outcomes would be to ensure physician awareness is increased, not to enact a state by state solution.
Numerous recent studies point to declining spending on prescription drugs. The Centers for Medicare & Medicaid Services (CMS) Office of the Actuary (OACT) released the Federal government's figures on national health care spending for 2007 which show an ongoing sharp decline in retail prescription drug spending growth, leaving medicines as one of the slower growing areas of health care expenditures. Prescription drug spending growth reported by OACT's National Health Expenditures has now declined in seven of the last eight years, and dropped from a peak of 18.1 percent in 1999 to 4.9 percent in 2007.1 That same data showed the decline in prescription drug spending accounts for more than half of the reduction in overall health care spending growth from 2006 to 2007, even though drug spending accounts for only 10 percent of total health care spending.
The Business Council does not believe the mandates within this bill would achieve the goals of reducing health care costs; improving patient safety; or using data to better inform product safety and product development. For these reasons, The Business Council opposes A.6929.
1 M. Hartman et al., “National Health Spending in 2007: Slower Drug Spending Contributes to Lowest Rate of Overall Growth Since 1998,” Health Affairs January/February 2009.