Free Speech vs. Medical Privacy Hits The Supreme Court
from the seems-like-a-stretch dept
I'm a big First Amendment advocate, but there are certainly times when people claim First Amendment rights that don't make much sense. Take, for example, the case that the Supreme Court recently decided to hear, Sorrell v. IMS Health, in which pharmaceutical companies are claiming a First Amendment right to use data from pharmacies to market to doctors.The details involve a Vermont law that forbids data-mining companies and pharmaceutical firms from buying up prescription data, compiled by various pharmacies as required by law, to then go and market certain drugs directly to doctors. As you probably know, pharmaceutical firms spend billions every year trying to convince various doctors to prescribe their brand name drug, over the much cheaper generic equivalents (this "marketing" often involves ethically questionable practices). Thus, the data of what's being prescribed is really useful. The Vermont law said that this data couldn't be sold to data mining firms or drug companies without the doctors' consent. The 2nd Circuit appeals court said the law violated the First Amendment. Similar laws from neighboring New Hampshire and Maine had been upheld as Constitutional in the 1st Circuit, which is probably why the Supreme Court agreed to hear this case now -- to settle the split between the lower courts.
In this case, it seems like the 1st Circuit rulings make more sense. The key issue isn't even really the First Amendment rights of the companies to make use of this data, but that the data is available at all. The reason the marketing firms and pharmaceutical companies have access to that data at all is because the government requires the pharmacies to collect such data. Thus, it seems reasonable for governments to also then restrict how that data is used and/or sold in the interest of medical safety. It's not as if the data is public, and it's only being collected at the behest of the government. So it seems like a stretch to claim that this data, which is only available due to a government requirement, can't then include other restrictions.
Thank you for reading this Techdirt post. With so many things competing for everyone’s attention these days, we really appreciate you giving us your time. We work hard every day to put quality content out there for our community.
Techdirt is one of the few remaining truly independent media outlets. We do not have a giant corporation behind us, and we rely heavily on our community to support us, in an age when advertisers are increasingly uninterested in sponsoring small, independent sites — especially a site like ours that is unwilling to pull punches in its reporting and analysis.
While other websites have resorted to paywalls, registration requirements, and increasingly annoying/intrusive advertising, we have always kept Techdirt open and available to anyone. But in order to continue doing so, we need your support. We offer a variety of ways for our readers to support us, from direct donations to special subscriptions and cool merchandise — and every little bit helps. Thank you.
–The Techdirt Team
Filed Under: first amendment, medical info, medical privacy, privacy
Companies: ims health, sorrell
Reader Comments
Subscribe: RSS
View by: Time | Thread
Excepting those few states where it is restricted, the sale of that data is now established an easy revenue stream for the retail pharmacy business.
[ link to this | view in chronology ]
Re:
[ link to this | view in chronology ]
Devil's Advocate
Should it be in the public domain at any time?
[ link to this | view in chronology ]
Re: Devil's Advocate
Should it be in the public domain at any time?
I assume (but am not sure) that this is PDMP ("prescription drug monitoring program") data. It's used mainly to monitor substances which are addictive, but legal with a doctor's prescription (e.g. codeine, oxycontin). It usually includes everything (including patients' names), and is accessible only by law enforcement or other government agencies.
But each state has different laws, and some allow the data to be used by private parties (so long as it is stripped of personally identifying information).
At least I think that's what's going on. It's about as good a guess I could make from the LA Times article and a quick Google search.
[ link to this | view in chronology ]
Re: Devil's Advocate
Since the infrastructure is in place to collect that information however, it is very simple for retail pharmacies to collect information about ALL prescriptions. This information is very valuable to the pharmaceutical industry to allow them to target their marketing strategies. As I stated previously, the government requirement is now immaterial since the retail pharmacies will continue to sell this information regardless (unless prohibited from doing so).
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Re:
I would expect the data to be aggregated in some form - "there were X prescriptions for this medicine during the following time period..."
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Re:
The pharmaceutical companies are therefore able to have their sales reps come into the physician's office and literally say "I know you prefer to write prescriptions for brand X. Can I have 2 minutes of your time to tell you why I think my brand Y is better than X."/
They may even say things like, "I know I'm not going to convince you to write my drug all the time, but can you at least give me 2-3 prescriptions per month, especially in those special circumstances where my drug has been shown to be superior to your favorite"
There is no patient specific information being collected, and therefore this is not a HIPAA issue.
[ link to this | view in chronology ]
Wht is the data collected in the first place.
[ link to this | view in chronology ]
Wht is the data collected in the first place.
As to the rest, Private insurances, that data should not be give out.
[ link to this | view in chronology ]
Re: Wht is the data collected in the first place.
[ link to this | view in chronology ]
I'm surprised
Open government and Open...anything... needs to have limits, like private medical records... of... I don't know... _maybe_ just maybe what prescriptions someone is taking.
Big Pharma knows how many pills they are making. Perhaps this should be a sign that Pharma shouldn't be allowed to market to doctors (or anyone else for that matter), there is no reason why pill commercials should be legal, they don't help the overall society, they just make us want more pills.
[ link to this | view in chronology ]
Re: I'm surprised
Actually, that's not correct, and I suspect it's the entire point of collecting the data.
With a ton of prescription drugs, there are either competing drugs (e.g. allergy medications), or generic equivalents. From a single drug-maker's perspective, either is bad for your business.
So, you gather data, and in any areas where patients are buying generics or competitors' drugs, you target the local doctors and hospitals with whatever bribes are currently legal.
[ link to this | view in chronology ]
Re: Re: I'm surprised
Although I would point out that the "bribes" have largely dried up in the past 3-4 years as appropriate public scrutiny of the process has been brought to bear.
Now there are no more free trips to the Bahamas, hardly any paid speaking engagements, almost no free "educational" lunches, no more free handbags at conventions, no pens, no more note pads, etc. etc.
There has been a huge vacuuming of 'drug money' dirt from the healthcare system lately.
Whether the money Pharma has saved will actually go into price reduction, or into new research is doubtful however.
How about bigger CEO bonuses as a reward for saving money perhaps??
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Umm question...
[ link to this | view in chronology ]
Corporations are NOT persons
There is a bit of a tortured history in the US over this issue, but I believe that some courts have ruled improperly over this issue. I also believe that corporations should NOT enjoy any of the rights enumerated in the Constitution. Those are reserved for individuals.
Here is an article that explains the issue, unfortunately behind a registration wall:
http://www.law.com/jsp/article.jsp?id=1050369429283
The article quotes Justice Renquist as believing that the precedent is weak.
So why should a corporation have First Amendment rights to begin with.
Not willing to register
[ link to this | view in chronology ]
Re: Corporations are NOT persons
Contract Clause as defined for corporations
Large problems with corporate sponsorship mean that people have a larger advantage with business money than a regular person. If the Judicial System ever takes away a corporation's "right to exist" it would effectively alter quite a lot of rulings in regards to business rights, consumer rights, corporate money in politics, etc.
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Re:
[ link to this | view in chronology ]
Re:
Heh. You know, I just ran across an article about this:
New Urban Myth: The Internet ID Scare
This is from the CDT, who are very concerned (to put it mildly) with citizens' privacy and control.
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Glad I'm Canadian
[ link to this | view in chronology ]
Re: Glad I'm Canadian
HIPAA was sold to the American public as a protection against disclosure of their private information.
In fact, HIPAA was one of the greatest political sleight-of-hand maneuvers in a long time. Prior to HIPAA, there were situations in which patients and/or physicians were able to deny medical information to their employers or their insurers on the basis of privacy. HIPAA guaranteed that by law, that employers who offer insurance benefits, and insurers always have access to medical information.
It is now a very expensive mistake for a health-care provider to inadvertently allow a patient's information to be seen by an uninterested 3rd party, whereas the very people who patients didn't want to see their information have an unequivocal right to it.
[ link to this | view in chronology ]
commercial vs non-commercial Speach
This is fine for me and I for one wish it would be more strenuously applied to corporations in the area of political contributions and lobbying. The fact that you are a corporation makes your speech inherently commercial. Lobbying is inherently commercial. If it were not commercial, for profit corporations would not do it and if they did it would not be deductible as a business expense since it was not in furtherance of earning income (the IRS standard not mine).
PRK
[ link to this | view in chronology ]
Not all pharmacies give IMS information. There is no IMS data from Walmart. Of course, Walmart might sell the information themselves, but that is their choice. They are selling doctor prescribing information, not information on what drugs you take.
Of course, one time a drug was recalled and the company was trying to figure out who actually received that drug. They looked at the IMS data and realized that the pharmacy patient ID looked like a phone number. Once they realized they had in their system actual identifying information of the person (or household) who took their drug, they deleted it from their systems as that was a violation of the law.
[ link to this | view in chronology ]
buycocaineshop.com
Purchase bio cocaine, carfentanil, fentanyl, hashish, Abortion Pills and Psychedelics, Cannabis Strains, Wax, Hash, Cocaine, Nembutal, Ecstasy Pills, Cocaine Hydrochloride, LSD sheet, DMT, buy medical cocaine for sale at http://buycocaineshop.com/
[ link to this | view in chronology ]