Dispute over use of MDs' prescribing information heading to court

A Toronto company is challenging a controversial ruling by Canada's privacy commissioner that the collection and sale of information about physicians' prescribing habits does not violate their privacy. The CMA, which also disagreed with the ruling, is seeking intervener status in the Federal Court case.

IMS Health (Canada) and other companies have collected prescribing data from pharmacies for years, and the information has been sold to pharmaceutical companies for about 10 years. The companies use it for drug-detailing purposes, since the information identifies “high prescribers.”

Ronald Maheu, president of PharmaCommunications Group Inc. of Markham, Ont., filed an application for an order requiring IMS to modify its practices in order to comply with the 1999 Personal Information Protection and Electronic Documents Act (PIPEDA). The company says IMS should be prohibited from collecting, using, storing and disseminating information about physicians without their knowledge and consent.

PharmaCommunications collects similar data for similar purposes, but Maheu says it gets the information directly from physicians, “so those who do participate do so with full consent and voluntarily. It places us at a significant disadvantage if our competitor can collect [information] without informed consent. The rules of the game should be applied consistently.”

IMS currently collects prescribing information from 4500 of Canada's 7000 pharmacies. It does not collect the data in British Columbia because the BC Ministry of Health has prohibited the practice.

“Data mining” from pharmacies is at odds with the CMA's 1997 policy on the collection and sale of physicians' prescribing data (CMAJ 2000;163[9]:1146-8).

Its use was challenged in 2001 when Dr. Albert Schumacher, past president of the Ontario Medical Association and a member of the CMA Board of Directors, filed a complaint under PIPEDA. In a September 2001 decision, Privacy Commissioner George Radwanski disagreed that prescriptions were “in any meaningful sense ‘about’ the physician. In looking at the issues that were raised and the act, I have to conclude that [this] is something that is really a work product, which is distinct from information about the individual.”

Radwanski refused to comment on the legal challenge because the case is before the courts.

IMS spokesperson Natalie Benoit says there are misconceptions about how IMS collects its information and how much is collected. She says physicians with similar prescribing habits are lumped into groups of between 30 and 200 on a provincial or national basis. For example, physicians prescribing cardiovascular medications are ranked in the order of the number of prescriptions they write, and IMS then states the average number of prescriptions all these physicians wrote for those medications. “It's not as precise as people might think,” said Benoit. “It doesn't say exactly what they prescribe.” — Barbara Sibbald, CMAJ