SINCE NO ONE doubts that universal healthcare in this state will be in trouble if costs keep spiraling, the Legislature wisely passed a health cost containment bill last week. Its biggest potential brake on rising outlays is its push toward computerization of medical records. But the most controversial part of the bill would curb rising healthcare costs in another way: by forcing the pharmaceutical industry to limit and disclose the gifts and fees it provides to doctors.
Supporters believe that drug companies use free meals and fees to influence physicians to prescribe costly new medicines, when older and cheaper ones could do the job just as well. But the biotech industry doesn't want the state looking over its shoulder and has called on Governor Deval Patrick to reject this section. If he is serious about controlling health costs, Patrick should sign the bill, with the clause restricting gifts.
The bill does not include an outright ban on gifts, as the earlier version did. Instead, it requires the state Department of Public Health to come up with a code of conduct that would be no less restrictive than two industry codes already in effect. The bill specifies that the state's code would allow companies to continue providing doctors with free samples of drugs for their patients.
Even though the bill does not include a complete gift ban, the industry still worries about the terms of the code that the DPH will draw up. Companies also object to the bill's requirement that firms disclose all their gifts and fees to physicians of more than $50, saying this would force them to divulge product development information to competitors and limit the number of clinical trials at the state's teaching hospitals. The competition argument weakens, however, in light of the mandate by Congress last year that all companies conducting clinical trials publish information about them on a government website.
Granted, those listings do not include names of doctors conducting trials or the fees they receive, but the industry goes overboard when it says the state's required information would "generate unwanted and unnecessary public attention and concern." Senator Mark Montigny of New Bedford, a backer of disclosure, gets it right when he says, "Taxpayers - and patients - have never lost through transparency." The more information, the better. The public should know whether the money Dr. X is getting from a drug company is for making well-paid speeches touting its new cholesterol medication or for leading a clinical trial on a new drug.
To keep costs down, the state is right to make sure doctors make medication decisions based on merits, and not meals.
