JiM, please cite a reference for your 19% number. If you like, I can cite the federal government is a reference that <12% of health care spending is on prescription drugs.

According to http://carlatpsychiatry.blogspot.com/2007/09/prescription-data-mining-transparent-ly.html The AMA makes over $40 million a year by leasing out its physician Masterfile.

The AMA doesn’t sell prescribing data. They don’t have access to this data. prescribing data is sold by pharmacies, and others who have access to it, to healthcare information companies. They compile all the data and license it back to pharmaceutical companies.

I’m not sure if you’re complaining about the headline, but I didn’t intend to be dismissive or insulting. I couldn’t fit Fugh-Berman in the headline. But I still wanted to personalize this somehow because it’s Q&A. Hope this helps.

Regards
ed

After all, the woman is a medical doctor and not merely an academic. I doubt that if she had been a male,she would have been addressed as such. By doing this, her views can be addressed out of hand because a) she’s a woman; b) she’s an academic. However, she is a medical doctor who knows what she’s talking about.

The AMA isn’t fully up to the task of regulating itself, because, despite free-market rhetoric, its job is to look after the health interest of the public. Oh, but that kind of contradictions its trade association mission, which is to look after its proprietary interests, right?

No one is begrudging MDs making a living, but there seems to be a conflict of interest in the AMA selling its members Rx information and giving Rx firms the inside track to it, and then developing a “plan” to merely mollify reasonable legislative oversight.

Irony is that much regulatory effort has gone into _defending_ free market. Kefauver hearings were originally about price-fixing and industry’s attempt to end competition. Antibiotics were central in all this, and thus is was the industry itself that was ready to flush away innovation encouraged by market.

Re: drug costs, latest estimates are closer to 19% of total medical costs. PhRMA has been using the lower number for a long time, but it doesn’t stand up to scrutiny.

Most of the physicians like that suffer from one terrible deficit in their education: they don’t understand the free market, capitalism and economics. The equation is simple, as Bruce pointed out: marketing drives sales, sales provide profits which in turn allow further risk-taking and development of potentially (POTENTIALLY) profitable products. Nathan has pointed out elsewhere that antibiotic research is in the toilet because it is no longer profitable.

If the objection is that because physicians like their reps they will prescribe more expensive drugs (and don’t we wish it were that easy), then let’s look at the core assumption driving this lament: medical care should be paid for by someone other than the patient. If you don’t concede that medical care is a “right” granted by the constitution and something that should be paid for all by the few, then you come down to patients being responsible for their own care–and perhaps then making cost-based decisions.

Granted that some sort of pooling of risk and consequent subsidization of care for some is necessary, that doesn’t mean that care should be “free” and therefore not scrutinized by the consumer. I think the vast majority of the populace should pay for most of their care–especially maintenance and preventive care. Let the subsidization process kick in with major expenses. Let patients choose among plans that offer more or fewer benefits such as branded drugs, IVF, sex-change operations, mental health benefits, etc.

And let’s not lose sight of the fact that drug costs are only about 12% of total medical costs in this country. You could ban drugs entirely and not make much of a dent in the medical economy of this country. And that’s assuming that the 12% that is spent on drugs does nothing to lower other costs, which is an erroneous assumption.

Let me repeat, I’m not arguing that physicians are too smart to be influenced by marketing…just that in a market economy marketing is what marketers do, subject to regulation. And that, whether or not an opt-in system is preferable, physicians *are* smart enough to opt out.

Assuming that we’re not going to change our economic system, those who have problems with marketing prescription drugs have every right to advocate specific regulatory measures to correct abuses or market distortions.

Remember, taking physician prescribing data out of the equation will do nothing in and of itself to stop the pharmaceutical industry from marketing to physicians…it will just make that marketing less precise.