-by Michele Kimball, state director, AARP Minnesota

At the Minnesota State Capitol today, lawmakers are hearing about important proposals to reform the way prescription drugs are prescribed in Minnesota.  AARP is pleased to be part of the Minnesota Prescription Coalition working to help this effort gain the attention it deserves  — and to ultimately pass these important reforms.

Why do we care? AARP represents about 700,000 consumers in Minnesota over the age of 50.  It comes as no surprise that older Minnesotans have a huge stake in this game because they are the biggest consumers of prescription drugs.

Prices of drugs continue to rise, having a direct negative effect on older and disabled Americans, especially those on fixed incomes. These are the Minnesotans who won’t receive a Social Security cost-of-living increase in 2010 because of low inflation of nearly every other sector of the economy.

Higher drug prices mean that Minnesotans enrolled in Medicare’s Part D drug program more quickly reach the “doughnut hole”—the coverage gap in which they must currently pay the full price of their medications.  To be sure, older consumers want policymakers to do whatever they can to control costs.

But it’s not just about drug costs.  It’s about quality, ethical health care – and about ensuring that our loved ones get the right drug and the right information whenever they visit a doctor.

Kim Witczak’s Story No one can speak to this issue better than Kim Witczak, a very brave consumer from Minneapolis who has become an expert on prescription drug issues since the death of her husband.

On August 6, 2003, Kim’s husband, Woody died of a Zoloft-induced suicide at age 37. He was not depressed, nor did he have any history of depression or any other mental illness. He died after taking the drug a total of 5 weeks with the dosage being doubled shortly before his death. He was given the antidepressant from his general physician for “insomnia.”

Kim told Minnesota’s lawmakers that Woody loved life. He was a compassionate, loyal husband, son, brother, uncle, godfather and friend. He had endless energy, a constant smile and a laugh that could be heard a mile away. Woody had a successful sales career and had just started his dream job as VP of sales with a start up company. He was excited about this new opportunity and along with this excitement came difficulty sleeping. He went to see his family doctor and after a 5-minute consultation, he was given Zoloft for an insomnia diagnosis.  This was the first time he’d ever gone to a doctor for this sort of issue.   Read more about his story at www.woodymatters.com.

Kim talked about the current way we prescribe drugs and how Woody and his doctor became victims of a system that is too focused on marketing and profits.  Woody was given a 3-week sample of Zoloft by his general practitioner.  Insomnia is an “off-label” use for Zoloft.  Samples are a marketing technique used to promote drugs.

Marketing and Detailing

Too much of the information and research that doctors get about the drugs they prescribe comes from the drug companies’ representatives.  As Allan Coukell of the Pew Prescription Project testified today, spending on marketing and promotional goods by the pharmaceutical industry is estimated at nearly $30 billion – much of it directed at those who prescribe medications.  Drug reps visit the office to discuss the attributes of the drugs and to leave samples.  In fact, between 60-80 percent of all antidepressant prescriptions are written after about a 5-10 minute consultation by general practice or family doctors who may or may not know the significance of all the side effects.

From a consumer’s perspective, educating doctors about new drugs should not be left to marketers.  Doctors need nonbiased information and they need all the research available to know the risks of what they are prescribing.  Patients need to know that their health care providers are delivering the best care possible and that they are not swayed by gifts or other financial incentives.

Marketing and sales practices have no doubt compromised the doctor-patient relationship and have contributed to the skyrocketing costs of prescription drugs and the overall increase in health care costs.

So What Happened Today? The Minnesota Prescription Coalition and key legislative authors presented three bills today to help reduce the current conflicts or interest between pharmaceutical industry and doctors.

  • Legislation that will prohibit pharmaceutical companies from buying doctors’ prescribing records and using the information to target their marketing to individual doctors. Pharmaceutical Data Mining: S.F. 1044 (Sen. John Doll) and H.F. 491 (Rep. Tina Liebling)
  • Legislation that will ban gifts to providers from pharmaceutical manufacturers and improve transparency and reporting laws that more clearly define relationships between health care providers and pharmaceutical companies. Pharmaceutical and Medical Device Gift Ban:  S.F. 1237 (Sen. John Marty) and H.F. 1641(Rep. Tina Liebling)
  • Legislation to establish an “academic detailing” program to give physicians nonbiased information to make the best and most cost-effective decisions about prescriptions. Independent Prescriber Education Program “Academic Detailing” S.F. 895 (Sen. Kathy Sheran) and H.F. 1640 (Rep. Tina Liebling)
I believe that momentum is growing in Minnesota among consumers, providers and policy experts to establish objective, evidence-based methods of getting accurate information into the hands of physicians and other prescribers.

Dr. Chris McCoy, a physician in Rochester, and policy chair of the National Physicians Alliance spoke about how many doctors feel about the current marketing practices of pharmaceutical companies.  “Trust in the medical profession is slipping away as pharmaceutical companies buy influence through our systems,” said McCoy.  “Families and patients need to trust that doctors are making the best decisions, based on nonbiased information.”

I can tell you from my experience in conversations with AARP members here in Minnesota, frustration about the negative effects of the pharmaceutical industry’s marketing practices is at an all-time high.

We still have a lot of work to do.  The opposition to this legislation is out in force.  I believe that eventually, these bills will prevail.  Minnesotans are a very common-sense lot.  These bills make common sense for consumers, health care providers, insurers and government entities in Minnesota.