PROPOSED BILL THREATENS COMPLIANCE PROGRAMS

WASHINGTON (FNS) -- Pharmacy programs to ensure patients take their prescriptions properly and don't forget to refill them have come under fire lately, and lobbyists for chain drug stores want to set the record straight with members of Congress.What they're trying to head off are pending privacy bills designed to protect consumers against having their medical records improperly shared with marketing

WASHINGTON (FNS) -- Pharmacy programs to ensure patients take their prescriptions properly and don't forget to refill them have come under fire lately, and lobbyists for chain drug stores want to set the record straight with members of Congress.

What they're trying to head off are pending privacy bills designed to protect consumers against having their medical records improperly shared with marketing companies or others. These bills have been spurred, in part, by third-party contractors, hired by chain pharmacies, doing just that.

In two well-publicized cases earlier this year involving a contractor working for Giant Food, Landover, Md., and CVS, Woonsocket, R.I., an article in the Washington Post sparked numerous phone calls to the retailers from angry consumers concerned about their privacy rights.

The pharmacies had hired the direct marketing firm, which at the time had contracts with about 25 retail chains, only to track and write pharmacy customers who had not re-filled prescriptions.

Lawmakers have moved to head off future leaks, which is worrying a chain drug industry concerned that pending bills will unduly hamper their pharmacy patient compliance program. These programs have become an important managed- care initiative to curb the costs of further illness.

Commenting on the pending bill sponsored by Sen. James Jeffords, R-Vt., and Sen. Chris Dodd, D-Conn., a spokesman for Giant Food said the Jeffords-Dodd bill, as it stands, would be burdensome for business.

"The intent of the bill is very admirable, but the bill needs a lot of fine tuning," the spokesman said. "The extra paperwork and administrative detail it would create would be very costly and time consuming."

Giant officials are also looking at the issue of privacy. The retailer recently launched a task force to examine how customer information is protected in all aspects of its business, ranging from pharmacy and food stamp accounts to credit card and check cashing purchases, he said.

The proposed bill would require pharmacies to receive patient authorization not to involve them in a compliance program.

The bill also would require pharmacies to get a patient's okay to use prescription information for a "commercial advantage."

A lot of what pharmacists do, like substituting a generic drug for a brand-name -- which means receiving a bigger profit margin -- can be construed as gaining a commercial advantage, said John Coster, a lobbyist for The Legislative Strategies Group, Washington, who is also a registered pharmacist. Even compliance programs can be deemed as a money-maker.

The paperwork alone for maintaining various authorizations, which would have to be given each time a prescription is refilled, would also add to pharmacy costs and threaten compliance programs, he said.

The 30,000 pharmacies representing the chain drug industry fill about 60% of the $2.6 billion worth of prescriptions filled a year, an amount that is expected to increase significantly and has already increased 28% since 1992.

Compliance programs, while deemed important to improving patient health and ultimately reducing overall health care costs, also boost pharmacy sales. It's estimated that about 50% of patients properly follow their prescriptions, including directions to have them refilled.

The National Association of Chain Drug Stores, Alexandria, Va., held a news conference earlier this month to advocate the need for compliance programs and discuss legislation that could impede their effectiveness.

Speaking on behalf of NACDS, Joyce Cramer, a medical researcher at Yale University who's studied drug-taking behavior, figures that improperly followed prescriptions costs the medical system an additional $30 billion a year, either because of resulting hospital care, or additional medication and doctor visits required because medicine wasn't taken. An additional $50 billion is lost in business and worker productivity.

Compliance programs -- which can consist of counseling by pharmacists or direct-mail reminders advising consumers to refill their prescriptions -- "is an essential component of medical care," she said.

Because of an already crowded legislative calendar, it's considered unlikely patient privacy legislation might move until next year, said Rob Hartwell, vice president of government affairs at NACDS. However, the industry has time to lobby lawmakers to write a privacy law that doesn't throw a wrench in compliance programs.

In fact, the industry wants a federal privacy bill so companies operating in many states don't have to comply with a patchwork of state privacy regulations.