Wednesday, March 4, 2015

Fascinating: NOT "Paying for Prescriptions, Or Referrals" -- But Paying -- To Provide "Point Of Treatment" Alerts(?)

Yesterday's Wall Street Journal ran a story that deserves a little more thoughtful analysis -- related to the Merck Vaccines business units, and the intersection of inexorable commerce -- with increasingly common electronic patient care record-keeping. [And I guarantee you, many a family practice doc from the 1960s. . . would be moderately aghast -- at this new world. This isn't a "free sample" world, any longer -- at all.]

While several companies have offered various versions of this "instant alert" app/pop-up to doctors' iPads, phones or laptops as available tech for a few years, I for one was not aware that the vaccine makers, like Merck, were paying for the placements, to subsidize the app/software. And I was not aware that the latest business models include a "give-away" of the software -- to the point of care provider. Cheeky!

It strikes me that all of this is certainly lawful, so long as all interested parties are informed (patients included) that the doctor is getting a freebie, and a multinational pharma -- like Merck -- is covering the cost of that freebie, plus a profit margin for the software/app vendor. [Background on the other stories embedded in the graphic, at right, here.] Even so, the doctor featured in the article said he was unaware that Merck was paying for the pop-ups. As I say, a fascinating. . . . new world, indeed. From yesterday's Wall Street Journal, then -- a bit:

. . . .When Allan Treadwell views patient charts on his computer, a yellow alert sometimes pops up—a handy feature that tells him when a patient is due for vaccines for hepatitis B, influenza or other ailments.

“It’s a nice safety net,” said Dr. Treadwell, an internist in San Francisco.

Dr. Treadwell isn’t the only one who is pleased with the alerts. So is Merck & Co., which pays for the notifications sent to Dr. Treadwell and 20,000 other health-care providers. Medical-record software startup Practice Fusion Inc., which sells the alerts and displays them through its software, said that during a four-month study period ending in August, it observed a 73% increase in vaccinations—amounting to 25,000 additional treatments—compared with a control group. The company didn’t disclose its fees for delivering sponsored alerts but said it doesn’t take a cut of sales that result. . . .

I certainly think in at least a few vaccine arenas, for example, where Merck is the sole source (i.e., has a monopoly anyway), this presents very little concern. But if the pop-up advocates one brand of vaccine over another in a contested space (two or more vaccine makers). . . well, I think that at least raises ethical and disclosure questions for the point of care provider. So -- what does the readership think (as we wait for the transcript from the King v. Burwell oral argument at the Supremes, to become available later this afternoon). . . What do you think?

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