MEDICAL PRIVACY: Prescription Database Targets Customers
In a marketing practice that "some experts say raises new questions about medical privacy," several large drug store chains and "thousands" of independent pharmacies have been providing confidential patient information to a Massachusetts database company that profiles and targets patients who don't refill prescriptions. The Washington Post reports that Elensys, a Woburn, MA-based marketing specialist, uses data "to send personalized letters -- written on pharmacy letterhead and sometimes paid for by drug manufacturers -- that either remind customers to keep taking their medicine or pitch new products that will treat the customer's ailment." Elensys receives prescription information on millions of individuals from 15,000 pharmacies each week, using "some of the most sophisticated computer equipment available" to profile patients and send them "educational materials" about drugs available for their conditions. CVS Corp. and Giant Food Inc. are two pharmacy chains in the Washington, DC, area that send information to the firm.
Dr. George Lundberg, editor of the Journal of the American Medical Association, called the direct marketing tactics, known as "drug compliance programs," a "breach of fundamental medical ethical issues." He said, "Do you want ... the great computer in the sky to have a computer list of every drug you take, from which can be deduced your likely diseases -- and all without your permission?" Elensys describes itself in an Internet posting as "the leader in patient behavior modification programs" (O'Harrow, 2/15).
Today's Boston Globe reports that "CVS Corp. said yesterday it is considering suspending" the practice of sending confidential information to Elensys. "Stung by [Sunday's] disclosures in the Washington Post, CVS held high-level meetings all day yesterday at its Woonsocket, RI headquarters, before issuing a statement defending the program and asserting extensive measures were taken to protect confidentiality." The statement said, "CVS engages in a limited number of programs designed to educate customers about prescription therapy and improve compliance with their drug regimen. These programs in no way compromise the confidentiality of patients." Elensys backed CVS, defending itself in a statement last night that emphasized it "merely served as an agent of CVS, and the chain exerted sole control over the use of information" (Ackerman, 2/17). The Washington Post reported Sunday that officials at Giant and CVS defended the marketing program, "saying customers benefit from their reminders and from the information provided by drug manufacturers. Both companies said they value customer privacy and allow customers to remove themselves from participation by submitting an 'opt-out' form." A spokesperson for Giant "stressed that Elensys does not share its prescription database with third parties," and Elensys President Daniel Rubin "said drug companies never get access to the pharmacy's files." Instead, pharmaceutical companies decide which patient groups they want to target and pay Elensys and the pharmacies to mail information to those patients.
Breaking the Law?
Washington, DC, area Safeway pharmacies "backed away" last year from signing on with Elensys after Maryland and Virginia state regulators expressed concern that "drugstores or chains that release information to a third party may be in violation of state regulations." Virginia legislators in January introduced bills that would "expand prohibitions against the release of prescription data" by pharmacies. David Russo, president of the Maryland Board of Pharmacy, said the practice is "a breach of confidence, according to the state board."
A Larger Trend?
The Washington Post reports that the direct marketing is "part of a far-reaching move by drug manufacturers and pharmacies across the country to make greater use of medical information, new technology and sophisticated marketing techniques to sell more drugs. Rather than promoting their wares mainly to doctors," companies are targeting patients in hopes of influencing them to ask for specific prescriptions (2/15). The New York Times reports a parallel trend in which the "pharmaceutical industry is increasingly marketing mental health drugs directly to consumers." Manufacturers claim the information is useful to patients, while some doctors and patient advocates contend that "people with certain mental illnesses are much more susceptible to being manipulated than those with other medical problems." The Times reports that "[i]n the most aggressive example of approaching patients directly, Eli Lilly & Company said recently that it would offer scholarships to some schizophrenic patients who took Zyprexa, its new antipsychotic drug." However, Lilly's scholarship program was withdrawn last month after inquiries from the New York Times. Dr. Harold Eist, a former president of the American Psychiatric Association, "did not object to advertising of such drugs but said the collection of patient information was 'intrusive.'" He said, "The information could be sold to an insurance company or HMO that would then refuse to sell the person insurance or charge them a higher premium." He added that the information might also make its way to head-hunting firms, employers, even divorce courts (Freudenheim, 2/17).