Sometimes the data discloses the physicians’ names along with prescription patterns. Other times the prescribing information is linked to individual physicians through the American Medical Association (AMA) Physician Masterfile, a database of doctors who graduated from American medical schools, as well as foreign medical school graduates licensed in the United States. Although the AMA established best practice guidelines admonishing pharmaceutical industry representatives to keep prescribing data confidential, physicians find they are being confronted by drug reps about the details of their prescribing data.

Responding to physician complaints, the AMA created a Prescribing Data Restriction Program that enables physicians to deny sales reps access to their prescribing data. Doctors must request the ban, which lasts for three years, unless a doctor requests that it be lifted. However, the restriction does not extend to other personnel in the industry.

Drug profiles are expensive to purchase, and many believe this system adds to the cost of prescription drugs directly through the cost of operation and indirectly through encouraging physicians to prescribe more expensive brand-name drugs when a less costly generic is available.

In California, Assemblywoman Wilma Chan (D-Oakland) introduced ABA 262 in 2003 that would have banned use of prescription data for marketing purposes. Even though several amendments were added to modify the bill as a compromise, it was defeated, primarily through pressure from pharmaceutical and health care data companies.

To avoid all the issues that arise from selling prescription data, according to Dr. Sharon Levine, executive director of The Permanente Medical Group, Kaiser has never made its prescription records available to drug companies.

Earlier this year New Hampshire became the first state to enact legislation restricting physician prescription data for all commercial uses. Other states have proposed similar legislation, including Arizona and West Virginia.

The California Medical Association (CMA) is putting together an experimental program that will let physicians opt-out of having their prescription data shared, and/or will give physicians access to their own prescribing information and show how it compares with others in their specialty. Also, on a quarterly basis, educational information about the latest medications and developments in their field will be E-Mailed to participating physicians. Details of the program are under review, but it is expected to be operational in 2007.

The main argument for not restricting prescription data is its value for health care research and for public health purposes. If health care information organizations no longer profited from collecting prescription data, they would likely stop maintaining the data, which would make it less available for medical research and other beneficial uses. Go to www.ama-assn.org for more detailed information.