Columbia University Medical Center

Prescription Project Champions Changes In Medical Prescribing To End Conflicts Of Interest

February 12, 2007 Diana Pisciotta
617/784-5256 (c)
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The Prescription Project to promote science-based practice of medicine
(Boston, MA) The Prescription Project today called on academic medical centers, professional
medical societies and public and private payers to end conflicts of interest resulting from the $12
billion spent annually on pharmaceutical marketing. Building on a series of reforms
recommended last year in an article in the Journal of the American Medical Association (JAMA),
the project will conduct and publicize research on conflicts of interest, advocate for policy
reforms that will eliminate such conflicts, and promote prescription practices that are based on
scientific evidence.
“Although new medical drugs and devices are revolutionizing the practice of health care and
improving quality of life, America has a prescription drug problem: the prescribing practices of
doctors are being influenced by billions of dollars in direct-to-physician marketing,” said Robert
Restuccia, Executive Director of The Prescription Project. “When Americans visit their doctor
and get a prescription, they should know he or she is relying only on the best medical
information, not the latest marketing campaign.”
Americans filled a total of 3.6 billion prescriptions in 2005, an average of 12.3 retail
prescriptions per person. National spending on prescription drugs is nearing $200 billion per
year, growing at double the rate of other health services. In 2004, about 25 percent of drug
expenditures were paid for out-of-pocket, making cost-effective, evidence-based prescribing a
high priority for millions of Americans.
Supported by The Pew Charitable Trusts, The Prescription Project is an initiative of Community
Catalyst, a Boston-based health care advocacy organization, in partnership with the Institute on
Medicine as a Profession (IMAP). Funded by a $6 million grant from Pew, The Prescription
Project will work over the next two years with medical and consumer stakeholders, policy
makers and both public and private payers to:
• Document the scope of the problem and its impact on health care quality and cost;
• Collaborate with leading Academic Medical Centers (AMCs), physician organizations,
public and private health plans, consumer organizations, and policy makers to promote
best practices in prescribing;
• Assist AMCs and professional medical societies in adopting policy reforms; and
• Undertake a wide range of policy initiatives in partnership with public and private payers
to increase the use of evidence-based systems and reduce conflicts of interest. The recommendations for AMCs outlined in the January 2006 JAMA article were the product of
a joint committee of the American Board of Internal Medicine and IMAP. Since then several
prominent AMCs, including Stanford University, the University of Pennsylvania, and Yale
University, have enacted reforms consistent with those recommendations, but progress has come
piecemeal, not as the result of a concerted effort. The Prescription Project is the first
comprehensive campaign aimed at ending these conflicts at AMCs, in the professional medical
societies and among public and private payers.
“There is a crucial physician education component to this effort, and doctors must play a primary
role in driving change,” said David J. Rothman, The Prescription Project’s Associate Director,
President of IMAP and Professor of Social Medicine at the Columbia College of Physicians and
Surgeons. “For instance, by setting a standard that governs financial ties between the medical
profession and the industry, including prohibiting physicians from accepting industry gifts,
America’s academic medical centers and other medical leadership organizations can create best
practices and spur greater action by other physicians.”
In addition to focusing on the medical profession, The Prescription Project will promote policy
changes in the public and private sectors that reduce conflicts of interest and expand the use of
evidence-based medicine. Public and private payers spend billions of dollars a year on
prescription drugs. When these payers rely on information from industry marketing campaigns
rather than unbiased scientific studies, the result is higher cost and poorer quality.
“Patients should not have to worry if best scientific evidence, or the Szechuan shrimp paid for by
drug companies, is the basis for their doctor’s prescription,” said Jim O’Hara, managing director
of policy initiatives and the Health and Human Services Program at Pew. “We expect that the
Prescription Project’s research and analysis will drive a much-needed policy discussion in
academic institutions and professional societies across the country.”
The Prescription Project’s advisory group includes experts in medicine, policy and health
systems. Members include:
¾ Jerry Avorn, Chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at
Brigham and Women’s Hospital
¾ Patrick J. Brennan, MD, Chief of Clincial Effectiveness and Quality Improvement of the
University of Pennsylvania Health System
¾ David L. Coleman, MD, Chairman, Department of Medicine of Boston University
¾ Cathy DeAngelis, MD, Editor-in-Chief of JAMA
¾ Sharon Levine, MD, Associate Executive Director of Kaiser Permanente
¾ John E. McDonough, Executive Director, Health Care For All, Massachusetts
¾ Steven Nissen, MD, President of the American College of Cardiology
¾ Philip A. Pizzo, MD, Dean of the Stanford School of Medicine About Community Catalyst
Community Catalyst, Inc., located in Boston, Massachusetts, is a national nonprofit advocacy
organization that builds consumer and community participation in the shaping of the U.S. health
system to ensure quality, affordable health care for all. It works in numerous states with state
and local organizations as well as with other national organizations.
About IMAP
The Institute on Medicine as a Profession seeks to shape a world inside and outside of medicine
that is responsive to the ideals of professionalism. IMAP supports research on the past, present,
and future roles of professionalism in guiding individual and collective behavior. It aims to make
professionalism relevant to physicians, leaders of medical organizations, policy analysts, public
officials, and consumers. IMAP’s programmatic agenda is carried out through the Center on
Medicine as a Profession of Columbia University.
About The Pew Charitable Trusts
The Pew Charitable Trusts is driven by the power of knowledge to solve today’s most
challenging problems. Pew applies a rigorous, analytical approach to improve public policy,
inform the public and stimulate civic life. We partner with a diverse range of donors, public and
private organizations and concerned citizens who share our commitment to fact-based solutions
and goal-driven investments to improve society.