AMA debates medical records restrictions

The American Medical Association examined the pharmaceutical industry's use of confidential patient prescribing data during its annual meeting in Honolulu last fall.

Delegates from Texas raised the question of whether pharmaceutical companies were using patients' medical records, which contain names and prescription drug profiles, to market particular products to physicians rather than using them to further quality assurance and quality initiative functions.

If so, the Texas delegation contended, "using confidential patient information to market products breaches the confidentiality of patient medical information," and they recommended that the AMA "strongly encourage pharmaceutical companies to discontinue providing quality assurance/quality initiative prescription drug profiles to their marketing staff or other authorized persons for marketing purposes."

The delegation also resolved that the association should pursue legislation to prohibit the use of doctors' prescribing information for product marketing purposes by pharmaceutical companies."

Pharmaceutical companies are able to access patients' medical records because the AMA licenses its information databases to privately held information companies, such as Plymouth Meeting, PA-based IMS Health, for a fee.

The information companies use the databases to accurately verify physicians' identities, for example, but they may also sell the information to pharmaceutical manufacturers, pharmacy benefit management companies and managed care organizations.

Pharmaceutical sales reps, who receive the information from their home offices, can use the information to track how physicians are prescribing their product - and to whom. Once they have and understand the data, they can adjust their sales strategy accordingly.

The association opted to investigate the matter further and said it will work with the pharmaceutical industry to address their concerns. Its Board of Trustees will review the resolution and report their findings in 1999.

The association did not vote to propose legislation to restrict access to the physicians' prescribing records, although some delegates recommended doing so.

In the past, the Pharmaceutical Research and Manufacturers of America has expressed vehement opposition to restricting patient medical records. Doing so, the lobbying organization contends, would stunt the industry's ability to thoroughly and efficiently research, discover and develop new cures and treatments. Current research and development methodology depends on the availability of such records

PhRMA stated: "If researchers were denied access to this information, or were required to obtain patient consent for each use of such data, clinical and pharmacoepidemiologic research would be greatly hindered - to the ultimate detriment of patients." PR