Pharma Companies Not Prepared for AMA's IT Mandate

Only 20 percent of pharmaceutical companies are prepared for a July 1 deadline set by the American Medical Association (AMA) to change their IT systems so that doctors can "opt out" of having details of their prescribing behavior made available to sales representatives, according to a study conducted by the Gartner Group.

Even worse, many companies are going too far in their attempt to be compliant, potentially crippling their efforts to market to physicians, Dale Hagemeyer, research vice president for the Gartner Group, told PIR. "Some pharmaceutical companies have contacted their syndicated data sources, of which IMS Health is the largest, and asked them to 'hide' the data from them so they will be in compliance." Asking these companies to provide only sanitized or aggregate data is a "mistake," he said.

There are about 12 to 13 standard variables that pharmaceutical companies use to measure doctors' prescribing behavior, Hagemeyer explained. The AMA's new rule is intended to allow doctors to withhold this data from pharma sales reps if they wish to. But, he added, "the rule specifically states that the home office [of the pharma company] can still see all 12 [variables] and craft messages for [doctors who have opted out]. But they can't push it out to sales reps."

Thus, if they update their IT systems properly, pharma companies can still do targeted marketing to physicians who choose to opt out, crafting messages so that an otolaryngologist, for example, will only get marketing material relating to ear, nose and throat products. The difference is that sales reps would not be allowed to talk to the specialist about her failure to use the company's products.

Hagemeyer compares the marketing that pharma companies will be permitted to do with the physicians who opt out to a game of pin-the-tail-on-the-donkey. "I know where the donkey is and will guide you, the blindfolded person." So, for example, it is still permissible for the marketing department to tell a sales rep to "avoid a doctor entirely because he's not using any of the products in our therapeutic class." It's a no-no, however, for the sales reps to try to "reverse engineer" the prescribing behavior of a physician who has explicitly opted out.

Threat of State Legislation

The AMA took this step because it found in a series of surveys in 2004 that 26 percent of physicians want the ability to block their prescribing data from pharmaceutical sales reps, Hagemeyer said. "Physicians feel they are being browbeaten by the reps. The key word is 'feeling.'"

Physicians in California complained to the state legislature, and a bill was introduced that would have kept field reps from seeing physicians' prescribing data. The AMA stepped in to prevent the creation of a patchwork of state legislation on this issue, Hagemeyer explained. But if pharma companies disregard the AMA's new rule and a physican files a complaint, the organization says it will take "appropriate action." moreover, the threat of new state legislation could return.

Still, Hagemeyer said, much depends on sales reps' behavior. The AMA "says they will investigate, but how will a doctor know [that his prescribing data has been released] unless I browbeat you? If I have X-ray glasses on but don't drool as I walk down the street, how will anyone know?"

The report recommends that pharma companies should immediately:

Contact their sales force automation (SFA) vendor to find out when solutions that are compliant with the new rule will be available and for which software versions. "The crux of being compliant lies in rule-based data synchronization so that sales personnel calling on physicians who have opted out are given only a fraction of the normal physician-specific prescribing data," the report notes; Plan how to upgrade their current SFA systems if the "compliance enhancements" are not available for the versions they currently have; "Perform a conference room pilot to ensure that the synchronization rules are foolproof for physicians that have opted out," and; Train sales reps on the rationale for the restriction, emphasizing that they should not try to find ways to get around the rule.

Finally, pharma companies should not panic about the deadline. "The pharma companies don't realize that all is not lost because 26 percent of physicians say they will opt out -- we don't know if they will," said Hagemeyer. There will also be a grace period, he said, since a doctor who decides to opt out on July 2 would not be officially on the opt-out list until Oct. 1. Still, the time to act is now. -- Martin Gidron (mailto:mgidron@fdanews.com)