Conservatively Speaking

State Senator Mary Lazich (R-New Berlin) represents parts of four counties: Milwaukee, Waukesha, Racine, and Walworth. Her Senate District 28 includes New Berlin, Franklin, Greendale, Hales Corners, Muskego, Waterford, Big Bend, the town of Vernon and parts of Greenfield, East Troy, and Mukwonago. Senator Lazich has been in the Legislature for more than a decade. She considers herself a tireless crusader for lower taxes, reduced spending and smaller government.

Pharmaceuticals under attack at informational hearing

Government health care

The Senate Health Committee that I serve on conducted a joint hearing Wednesday with the Assembly Committee on Aging and Long Term Care about Prescription Drug Reform.  Only invited speakers were allowed to make presentations. It became quite evident very early on that the stacked hearing was orchestrated to attack pharmaceutical companies.

Nino Amato of the Wisconsin Coalition of Aging Groups initiated the proceedings proclaiming that pharmaceutical companies are out of control, spending $30 billion on marketing.

Peter Wychoff of Community Catalysts contended pharmaceuticals don’t spend enough on research and development and too much on influencing physicians’ choice of products, in other words, “gifting,” ranging from trinkets (free pens)  to steak dinners. Even small gifts, Wychoff asserted, create an obligation on the part of physicians to choose certain drugs.

Wychoff and other speaks are calling on Wisconsin to approve a law like one in Minnesota that bans gifts from pharmaceuticals to physicians of $15 or more. Federal legislation was adopted during March of this year. However, proponents say state legislation is necessary to further limit the scope of influence.

Not surprisingly, the first speaker in defense of pharmaceuticals was allowed to testify 90 minutes into the hearing. Marjorie Powell is the Senior Assistant general Counsel for PhRMA (pronounced “far-muh”), The Pharmaceutical Research and Manufacturers of America. PhRMA represents leading pharmaceutical research and biotechnology companies.

Powell chided Senate Health Committee Chair, state Senator Jon Erpenbach (D-Middleton), testifying that presenters were offered coffee that could be considered “gifting,” a conflict of interest. Powell told committee members PhRMA has a code about gifts that 50-60 companies voluntarily follow. Prior to Powell’s testimony, Dr. Tim Bartholow, Vice-President of the Wisconsin Medical Society stated that some health care providers in Wisconsin don’t allow pharmaceutical company representatives inside or on their facilities.

PhRMA spent $53 billion on research and development during 2008 according to Powell. PhRMA’s website says, “Industry-wide research and investment reached a record $65.3 billion in 2009.” Powell maintained that major advertising constitutes a small percentage of PhRMA’s activities.

Wisconsin, Powell testified, already has two academic detailing procedures in place. Academic detailing is a term used for the philosophy of using an evidence-based approach to prescribing medication.  Powell said Wisconsin physicians are required to take continuing medical courses about this issue, and the state Medicaid program has a review committee to ensure drugs are prescribed appropriately.

Robert Hunkler of IMS Health, a health information firm based in Connecticut questioned the need for state legislation, testifying that cost savings are negligible and that more restrictions and regulations could actually jeopardize patient safety.

Many questions remain about possible legislation to require disclosure by pharmaceuticals and physicians:

How necessary is state legislation given there is federal legislation in place?

It seems many health care providers are already voluntarily policing themselves, raising the question of necessity.

Will there be increased bureaucracy?

Will jobs be lost?

What will the impact be on the ability to research and develop new products?

What will the impact be on the ability of pharmaceuticals to market their products?

I concur with Dr. Tim Bartholow of the Wisconsin Medical Society who described himself as “hesitant to endorse legislation” until more extensive information is available.

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