On Wed., Nov. 20, as many readied their turkey dinners and packed the car, one Joseph Conn, staff writer for Modern Healthcare, wrote an article detailing the first week of hearings in the Maine prescriber data-mining case.  Little could Mr. Conn know what he had started.

On Wed. Nov. 26, one Mr. Terry Nugent, Vice President of Marketing at Medical Marketing Services, which buys physicians’ data from the AMA and pairs it with pharmacy records to make primo detailing food for pharmaceutical companies, wrote a letter.  This letter

Today, Mon., Dec. 3, not wanting to bring the French Revolution to the pages of Modern Healthcare any more than was necessary, we write back to Mr. Nugent here.

In response to Joseph Conn’s “Data-miners unite in Maine to block ‘opt-out’ Rx law”, Mr. Terry Nugent (Letters, Nov. 26) writes that the “law of unintended consequences” is reason to continue to allow prescription data-mining, or the sale of physicians’ data to pharmaceutical marketers.

But the pharmaceutical industry’s invasive sales scheme operates instead on the law of intended consequences; the industry spent $7.2 B in marketing to physicians last year alone because they know it changes prescribing patterns.  Mr. Nugent threatens that ending prescriber data-mining would cause marketing costs to “increase and inevitably be passed on to the patients and taxpayers of America,” but it’s a hollow threat because it’s already here.  That $7.2B and the $18B more spent in samples is exactly why brand-name drugs are priced radically higher than their generic equivalents, and consumers and payers are the ones stuck with the bill.

Mr. Nugent calls laws such as Maine and Vermont’s prescriber privacy acts “a waste of taxpayer dollars.” On the contrary, laws restricting the sale of prescriber data to pharmaceutical marketers bring down health care costs by ensuring that doctors base prescribing decisions on science, not biased marketing, and by making more room in their schedules for patient care and continuing education.

Though he calls legislators seeking to protect this patient-physician relationship “liars”and “leftist politicians,” Mr. Nugent’s strangest name calling comes just words later, when he likens the opponents of this invasive marketing tactic to Marie Antoinette. It’s an odd analogy, as the mythology of the French queen—a spendthrift leader whose excesses came at the expense of her subjects—calls more readily to mind the pharmaceutical industry, which lavishly gifts doctors, even as it violates their most important obligation to care for patients by buying their prescribing data and raising drug costs for the public.

Update: Dr. Narayanachar Murali, a gastroenterologist from South Carolina writes to Modern Healthcare, thanking Mr. Nugent for educating him on the AMA’s sale of doctors’ data for marketing, and intimating that if more doctors knew about this  practice, the professional medical association might have a suit on their hands.

Second update: Mr. Nugent writes back. This time he brings Adam Smith and fall of the T-model Ford to the defense of his middle-man industry.

His middle-man industry: The MMS homepage trumpets that as “the first company franchised to manage the AMA Physician list,” it has “developed a proprietary, multidimensional, identification process to convert data into perfect prospects. Translation? When it comes to selling out doctors to pharma, we’ve got it down to a science.  Check out the company website here, including the montage of doctor portraits across the top. Did they all agree to their data being sold to Big Pharma? [And is that Dr. House on the right?]

Excerpt: “Murali prescribes ‘iron-fist’ regulation of the pharmaceutical market; my second opinion is the ’invisible hand’ of the market, which has guided our nation to worldwide economic pre-eminence.”

We still have unanswered questions: Where are the Modern Healthcare referees?  When Dr. Murali wrote about the iron-fist, was he alluding to despotic regulatory tactics, the Marvel superhero, or the heavy metal album?  We may never know.

And so, unable to channel either Adam Smith or Joseph Stalin, PostScript has declined to respond to Mr. Nugent’s second letter.

But we’ll be sure to keep watching the data-mining hearings in Maine and the pages of Modern Healthcare for more on this issue.