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    A Times Editorial

    Patients as pocketbooks

    The state's investigation of Eckerd Corp. shows the extent to which personal medical information has become a valuable commodity for drug manufacturers.

    © St. Petersburg Times
    published July 14, 2002

    Gone are the days when your local pharmacist would hand-deliver needed medications to your child's sick-bed. No longer is your pharmacist likely to be a trusted friend, like the family doctor of old who treated your coughs and earaches when you were a child. Big drugstore chains with revolving-door pharmacies have swept those intimacies aside, replaced by discount pricing and mass advertising.

    Now those chains have gone one step too far down the road of viewing their customers and patients as mere pocketbooks. Across the state, large drug store chains have been misusing their customers' private medical information to benefit the marketing programs of drug manufacturers and their own bottom lines.

    An investigation by Attorney General Bob Butterworth found that the Eckerd Corp. had been slyly misleading its customers, making them targets of lucrative drug manufacturer promotions without their consent.

    Here's how the ploy worked: Customers picking up their prescriptions were directed by Eckerd employees to sign a form indicating that they waived consultation by a pharmacist. The signature was a necessary legal requirement. But while the large print indicated that customers were acknowledging the consultation waiver, the tiny print at the bottom of the form said something much more self-serving. By signing, customers were in fact authorizing the pharmacy to release their prescription information to Eckerd Corp. so it could send them information on promotional drugs.

    According to Butterworth's office, pharmaceutical companies paid Eckerd $2 for every letter sent urging customers to ask their doctor about a new medication.

    Eckerd says it never shared its customers' sensitive medical information beyond the company's use and admitted no wrongdoing, but it agreed to settle the state's claims by endowing a $1-million ethics chair at Florida A&M University's School of Pharmacy. Eckerd will also change its forms so customers will no longer receive promotions without explicit consent.

    Eckerd's actions are indicative of the way too many doctors, insurance companies, drug companies and pharmacies operate these days. "Patients first" has now become "profits first," and there is little impetus to turn back the clock.

    Personal medical information has become a highly valuable commodity. Drug manufacturers are hungry to exploit the data, and those charged with holding our confidential medical files are too willing to serve as the conduits for marketing schemes if the price is right.

    In South Florida, a woman is suing drug manufacturer Eli Lilly & Co., a group of doctors and the drug store Walgreens, after she received an unsolicited trial pack of once-a-week Prozac in the mail. After news of the suit became public, Butterworth's office promised to investigate.

    The woman alleges that the doctors used their patients' confidential records to promote this new form of antidepressant on behalf of the drugmaker and with the assistance of Walgreens. The woman suing said she hadn't taken Prozac for years, and had a bad reaction when she did take it.

    Putting aside the danger of sending unsolicited prescription drugs in the mail, these kinds of advertisements could easily fall into hands other than those of the intended patients, destroying confidentiality. Eckerd Corp. is already being sued by a man who was sent a promotional mailing about a new HIV drug.

    Butterworth, who continues to be a friend to the consumer, should investigate these practices full tilt. As the drugstores and pharmaceutical companies increasingly view our ailments and health problems as profitmaking opportunities, we need someone to be keeping an eye on them.

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