Last Friday, the Globe got its mitts on the draft regulations for the pharmaceutical company gift ban. Monday morning I wrote a post decrying the lack of a disclosure requirement for pharma companies disclose how much and to whom they're paying for clinical trials. State Department of Public Health chief John Auerbach was kind enough to take a few minutes with me yesterday to give the department's case.
Auerbach attests that the disclosure requirement would simply drive clinical trial business out of the state. He says the result of such an action might be comparable to Massachusetts losing stem cell research business after Gov. Romney restricted such research in the Commonwealth. He concedes that Massachusetts is in a strong position for clinical trial business; but says that trials treating such common diseases as diabetes and certain kinds of cancer can be done any number of places.
Well, maybe. And maybe not. I also talked with Lisa Kaplan Howe of Health Care for All, who points out that Minnesota and Vermont, for instance, already have gift bans in place. And disclosure advocates have been pushing for a Minnesota-style disclosure requirement. (Minnesota, in fact, is considering expanding their disclosure law to include device makers.) So Massachusetts would not be alone. She also claims that the fear that companies would have to share critical information with competitors is overblown: Companies have analysts that find out what kinds of drugs competitors are testing, in any event.
Look, if you make the case that Massachusetts would be giving up business, and therefore not reap any public-information benefit from such a disclosure requirement anyway, I guess you might concede the state's point. But I don't believe PhRMA when it says it would just pull out of Massachusetts. They cry wolf so often they must be dehydrated. They didn't pull out of Minnesota. They won't pull out of here. They need what we've got; Gov. Patrick sweetened the pot for them with the biotech bond bill; and I just don't think that disclosure is the business-climate WMD that PhRMA would like us to believe.
If anything, research in which payors and payees are completely public ought to be more credible than that which is shrouded in mystery. Drug cos might be able to say, “Our research is credible and transparent — the state made us do it that way.”
In any event, disclosure is a very, very mild form of regulation — as Sen. Marty of Minnesota says, “”Disclosure isn't enough, but it's a good first step.” And the further the state goes towards taking medicine out of the realm of folkways n' marketing, and towards providing real information to the public, the more likely we are to get a handle on costs.
ADDENDUM: This cracks me up: nofreelunch.org. Awesome. There is, indeed, no such thing as a free lunch.
Another update: Public hearing dates and emails, thanks to the Dept of Public Health:
January 9, 2009
Henry I. Bowditch Public Health Council Room
250 Washington Street, Boston, MA 02108
January 12, 2009
UMASS Medical School, Amphitheater I, 2nd Floor
55 Lake Avenue North, Worcester, MA 01655
Or comment to: Reg.Testimony@state.ma.us. They say: “Please submit electronic testimony as an attached Word document or as text within the body of an email and type “Pharma / Med Device Regulation” in the subject line. All submissions must include the sender’s full name and address. The Department will post all electronic testimony that complies with these instructions on its website.”