Bills target marketing of drugs to doctors
By Karen Blakeman
Advertiser Staff Writer
Two bills introduced at the Legislature would attempt to hold down the cost of prescription drugs by countering the high-pressure promotional tactics pharmaceutical companies sometimes use to promote their products.
House Bills 13 and 19 would require drug manufacturers to disclose how much they spend wining and dining physicians to get them to prescribe their company's medicines.
"The pharmaceutical companies go to some pretty extravagant means to market their products to doctors," said Rep. Roy Takumi, D-36th (Pearl City, Palisades). "Trips to the Bahamas. Golf trips. Dinners at some pretty expensive restaurants."
Takumi said he introduced HB 19 before he was aware that HB 13, introduced by Rep. Cynthia Thielen, R-50th (Kailua, Mokapu), contained a similar provision.
"It was a case of two people coming up with the same brilliant idea at the same time," Takumi said.
Reps. Ken Hiraki, D-28th (Iwilei, Downtown, Makiki), and Dennis Arakaki, D-30th (Moanalua, Kalihi Valley, 'Alewa), joined Thielen in co-sponsoring HB 13, and Takumi signed on.
In addition to the disclosure requirement, HB 13 calls for the state Health Department to develop a program that would provide information to physicians on the effectiveness and cost of prescription drugs, independent of information distributed by pharmaceutical companies.
Most doctors, Thielen said, get information on prescription products through marketing directed at healthcare providers or consumers. "I'd like to stop the direct-to-consumer advertising altogether," she said. "But because of the commercial free-speech right for the drug companies to advertise, that may not withstand the (legal) challenge."
Providing an independent source of information will help doctors compare drugs, Thielen said. Information about the amount of money pharmaceutical companies spend to urge healthcare providers to prescribe their drugs will help consumers see why their healthcare budgets are spinning out of control.
"I would like to say to the drug companies: Show our physicians the technical information that will allow them to decide whether a particular drug is right or wrong for their patients," Thielen said. "And don't try to hype your drugs to the public like they were Pepsi or Big Macs."
Takumi said drug companies' marketing budgets are often double the amount spent for drug research and development, and sometimes three or four times as much.
Direct-to-consumer marketing has led doctors to overprescribe expensive drugs for conditions that might be controlled by over-the-counter preparations, he said.
Hiraki said U.S. healthcare providers buy drugs individually, while countries with national healthcare systems can buy in larger batches, and thus charge their customers a fraction of what Americans pay.
Bus companies that cater to the elderly have organized tours to Canada and Mexico to buy less expensive prescription medicines abroad. The practice is illegal, but authorities are often reluctant to arrest grandparents trying to halve the cost of their blood pressure medication, Hiraki said.
Takumi said several East Coast states are looking into forming purchasing pools, to buy prescription drugs at lower prices and pass the savings on to residents.
He hopes Hawai'i would eventually join such a pool. The state passed a law last year to form a buying pool that would allow residents without drug benefits to buy drugs at a discount.
Reach Karen Blakeman at 535-2430 or kblakeman@honoluluadvertiser.com.
