Senate kills drug sample tracking

Times Argus, Vermont Press Bureau
Published: May 5, 2010

MONTPELIER – The Vermont Senate easily passed a major health care reform bill Tuesday night, but first lawmakers jettisoned a provision that would have allowed the state to track free drug samples given to doctors.

The health care bill, S.88, passed with strong support in a voice vote shortly after 7 p.m., but much of the debate focused on a plan that would require the drug companies to report to the Vermont Attorney General when they give out free pharmaceutical samples.

Lawmakers approved an amendment offered by Sen. Richard Sears, D-Bennington, that removed the free sample provision from the bill in a vote of 18-10. It's not clear yet how House lawmakers, who included the language in the bill, will respond.

Sears said he worried that the provision would have a "chilling effect" on doctors in Vermont, leading them to no longer accept the free drug samples from the pharmaceutical companies.

"Some people have suggested that I am doing this because of the drug companies," Sears said. "Nothing could be further from the truth."

The defeat was a disappointment for lawmakers who say that the free samples given out to doctors – while beneficial when given out to some patients, especially those who are low-income – is nothing more than a marketing attempt to promote new and more expensive medications.

Sen. Jeanette White, D-Windham, said that a survey by the Vermont Medical Society last year found that only 38 percent of doctors might stop accepting samples if that information was made public. White pointed out that under the bill the information would only be given to the Attorney General's Office.

"Pharmaceutical companies do this because they are in the business of selling drugs and making money," said Sen. Doug Racine, D-Chittenden, the chairman of the Senate Health and Welfare Committee and the main sponsor of S.88.

"I don't believe that [doctors] will stop giving out samples," Racine added.

Ken Libertoff, the executive director of the Vermont Association for Mental Health, has pushed for more transparency between the drug companies and physicians. He said free samples are such a "brilliant marketing device that it actually blinds people who need to consider the role they play in access to affordable health care."

"From our perspective, the pharmaceutical industry had a victory today," Libertoff said. "That's disappointing, but it doesn't affect the positive changes that were made last year."

Last year lawmakers passed one of the strongest laws in the country banning most financial contact between the companies that make drugs and the physicians that prescribe them. A report from the Attorney General this year showed that drug companies spent $2.6 million lobbying Vermont doctors in 2009 before the ban took effect.

Many lawmakers said they heard concern about the provision from their local doctors. One of the most vocal critics of the provision was Dr. Deb Richter of Montpelier, who said the proposal implies that doctors are doing something unethical.

"We also must tell you we find it offensive at the implication that our prescribing patterns are influenced by the samples we receive," Richter and five other doctors wrote in a letter to Attorney General William Sorrell.

Much of the rest of the health care bill was less controversial than the free sample provision.

The portion of the bill written by Racine, one of five Democrats running in the gubernatorial primary this year, focuses on designing three new health care models for Vermont – including a single-payer system and a public health insurance option.

The bill also caps annual hospital budget increases, expands the popular Blueprint for Health program and sets up three pilot programs to investigate payment reform options in the state.

Racine said Vermont needs to address health care costs now before the price tag rises. The cost of health care in the state is expected to increase by another $1 billion between now and 2012.

"There is a real imperative for us to figure out new ways to pay for health care in Vermont," said Racine.

An amendment offered by Sen. Tim Ashe, D-Chittenden, to reduce the compensation for Blue Cross - Blue Shield's Board of Directors failed in a vote of 19-10. The insurance company found itself at the center of a political controversy last year when it was revealed that the outgoing president was paid millions of dollars in bonuses.