Transparency is good medicine

Transparency is more than a buzzword. It describes how good public policy is made and it’s why I introduced Senate Bill 5917, requiring pharmaceutical companies to disclose their spending on marketing to physicians.

Washingtonians value openness in government. In 1972, voters approved Initiative 276, requiring government to share documents with the public. Shining light on hidden facets of government lets us become smarter participants in the democratic process.

As a state elected official, I have to disclose certain financial data to the Public Disclosure Commission. Lobbyists, too, disclose how much they spend to influence the legislative process. It makes sense that pharmaceutical companies disclose what they spend on lobbying physicians.

Why? Because marketing by drug companies often determines which pills get prescribed, not whether the drug is the best available. Clearly health care consumers should know how this marketing money is spent so they can make an informed choice. With state drug purchasing plans, taxpayers should know how their money is used.

If that doesn’t convince you, consider this: Americans spent a staggering $213 billion last year on prescription drugs, at a rate of growth of 5.8 percent over 2005. With drugs being the fastest-growing component of health care spending, it’s no wonder that health care costs are skyrocketing.

The Center for Policy Alternatives reports that drug manufacturers spent $22 billion on direct marketing to U.S. doctors in 2003. That amounts to about $25,000 per physician annually. Studies have consistently proved that the visits by sales reps causes doctors to prescribe the latest drugs, even when there is overwhelming evidence that less expensive, proven remedies would be significantly cheaper, equally effective, and in many cases, safer. Why would pharmaceutical companies spend $25,000 per physician if it weren’t profitable?

These sales visits drive up drug costs for individuals, insurance programs and state governments. They also pose challenges to the principles of medical professionalism. Studies have uncovered indisputable evidence that even small gifts have tremendous power in influencing favorable attitudes toward products.

To this end, medical centers and states are moving to require full disclosure. Stanford University Medical Center and the Yale Medical Group have put into place policies banning meals and gifts to physicians. Eight states have laws or resolutions limiting pharmaceutical marketing. Last year, the American Medical Student Association registered its support of the federal Physician Gift Disclosure Act as a way to expose the influence of drug companies on doctors. It points out that as taxpayers and patients fund government health care programs, they should know how pharmaceutical companies are influencing doctors through gifts. Along this line, the University of Washington Medical Student Association endorses my bill.

The pharmaceutical companies have expressed concern that letting the public know about the “gifts” they make to doctors will expose “trade secrets.” Yet the states that have enacted similar laws have caused no harm to the drug companies — other than shedding some light on this practice.

If pharmaceutical companies have nothing to hide, then why do they object to disclosing information on their spending practices, as required by the bill? My family finances are public record. The spending of the drug industry’s lobbyists is also available. It’s time that we all played by the same set of rules.

Editor’s note: Sen. Jeanne Kohl-Welles, D-36th Legislative District, is chair of the Senate Labor, Commerce, Research & Development Committee. She also serves on the Senate Health & Long-Term Care, Rules, and Ways & Means committees.

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