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New Hampshire Amends Patient Privacy Law Following IMS v. Sorrell Decision

May 11, 2012 — In the wake of the June 2011 U.S. Supreme Court decision in IMS v. Sorrell, which ... read more

CMS: Sunshine Act Data Collection Will Be Delayed Until 2013

May 7, 2012 — The Centers for Medicare & Medicaid Services (CMS) stated on the CMS blog that following its ... read more

Guest Column: Heavy Meddle by Peter Pitts

May 7, 2012 — The American Recovery and Reinvestment Act (aka, “the stimulus package”) provided AHRQ with $29.5 million for ... read more

Proposed OTC Drug Distribution Would Expand Patient Access to “Rx” Drugs

April 30, 2012 – Comments are due May 7 on an FDA-proposed paradigm that would allow the agency to approve ... read more

PDUFA V Bills Moving Forward Without Specific Marketing Provisions

April 23, 2012 — The House and Senate both issued draft legislation last week to reauthorize the Prescription Drug User ... read more

CHC and TAC Comments Object to “Dual Modality” Risk Communication in DTC TV Ads

April 16, 2012 – The Coalition for Healthcare Communication (CHC) and The Advertising Coalition (TAC) recently told the FDA’s Office ... read more

ACRE Study Finds Medical Journal Discussion of Academic/Industry Relationships Unbalanced

April 12, 2012 – The Association of Clinical Researchers and Educators (ACRE) announced yesterday the publication of a study in ... read more

FDA Draft Guidance on DTC TV Ads Raises Important Questions

By John Kamp April 9, 2012 – The only thing really clear about the new guidance on pre-review of the ... read more

FTC to Industry: Adopt Consumer Privacy Best Practices Now

March 28, 2012 – Industry members needing another reason to join the fray of companies participating in the Digital Advertising ... read more

Call for Industry Comments: Proposed FDA Study on “Corrective” DTC TV Advertising

March 26, 2012 – Note to Industry Leaders The Coalition for Healthcare Communication needs your input on a study FDA ... read more

New Video Highlights Advances in CME Conflicts of Interest Policies

March 19, 2012 – A new video produced by CME Peer Review – “Conflict of Interest: The Bottom Line” – ... read more

FDA Draft Guidance on DTC TV Ads Identifies Campaigns Subject to 45-day Pre-Review Process

March 13, 2012 – Draft guidance released today by the FDA – “Guidance for Industry Direct-to-Consumer Television Advertisements” – calls ... read more

DAA’s Self-regulatory Ad Program to Protect Consumers Online Is Praised by White House, DOC and FTC

 Feb. 23, 2012 – At a White House meeting held today to unveil the blueprint for the Obama Administration’s “Consumer ... read more

Coalition Calls for Substantial Revisions to Sunshine Act Proposed Rules

Feb. 16, 2012 – Further notice and comment are necessary for the implementation of Section 6002 of the Affordable Care ... read more

Digital Health Coalition Issues Guiding Principles and Best Practices to Help Lead Way on Robust Use of Social Media by Medicine Companies

Feb. 7, 2012 – Responding to patient and professional calls for more industry participation in the Internet and social media, ... read more

Digital Advertising Alliance Launches Consumer Education Campaign

Jan. 27, 2012 – The Digital Advertising Alliance (DAA) last week launched its “Your AdChoices” public education campaign to inform ... read more

MMM: CME Video Addresses Conflict of Interest

Jan. 26, 2012 – Avoiding conflict of interest in continuing medical education (CME) may seem like a daunting task, but ... read more

Does Novo Nordisk’s Victoza + Paula Deen = Recipe for Success?

Jan. 20, 2012 – Common sense should tell people that some of celebrity chef Paula Deen’s infamously unhealthy dishes – ... read more

Sunshine or Rain?

By Jack E. Angel, Education Foundation Executive Director, Coalition for Healthcare Communication Jan. 17, 2012 – The Affordable Care Act ... read more

MMM Features Kamp’s Call for Industry Leadership on Off-label, Online Communications

 Jan. 6, 2012 — This article, written by Coalition for Healthcare Communication Executive Director John Kamp, was featured in the ... read more

FDA Issues Draft Guidance on Unsolicited Off-label Info Requests, Addresses both Professional and Internet Media

Jan. 2, 2012 – In the waning days of 2011, the FDA released a significant draft guidance on company responses to ... read more

FDA Approval Report Contains Good News for Patients and Industry

  By John Kamp, Executive Director, Coalition for Healthcare Communication – Nov. 7, 2011 – Until the research labs and ... read more

RPM Report: Pandora’s Box Officially Open as New Legal Challenges to FDA’s Off-label Restrictions Emerge

Oct. 24, 2011 – After the U.S. Supreme Court struck down speaker- and content-based restrictions in Sorrell v. IMS Health, ... read more

Par Pharma Case Asserts That First Amendment Protects Truthful Off-label Speech

Oct. 18, 2011 – A case filed by Par Pharmaceutical, Inc. against the FDA seeks to preserve Par’s First Amendment ... read more

Kamp on the Sunshine Act: Collaboration Key to Patient Care

Dec. 14, 2011 — UPDATE — CMS has published the proposed rules enforcing the Sunshine provisions of the Affordable Care ... read more

Experts Weigh In on Implications of Sorrell Decision

Aug. 1, 2011 — The recent Supreme Court decision in Sorrell v. IMS Health Inc. is earning robust commentary in ... read more

Academic Detailing and Health Plan Communications: Is the Playing Field Level?

By Kenneth P. Berkowitz, Esq. July 21, 2011 — Why does the government fail to apply current regulatory requirements and ... read more

Sorrell v. IMS: What Marketing Professionals Need to Know

By John Kamp, Executive Director, Coalition for Healthcare Communication July 18, 2011 — For those who have not read the ... read more

Kamp Column: Industry Must Embrace Internet and Social Media or Become Irrelevant in Many Health Conversations

By John Kamp, Executive Director, Coalition for Healthcare Communication June 29, 2011 — Yesterday I had the pleasure of moderating ... read more

PhRMA Survey Shows That Physicians Value Industry Communication

March 31, 2011 — At a time when interaction between biopharmaceutical companies and physicians is under increased scrutiny, a recent ... read more

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Academic Detailing and Health Plan Communications: Is the Playing Field Level?

By Kenneth P. Berkowitz, Esq.

July 21, 2011 — Why does the government fail to apply current regulatory requirements and rules to health plans and academic detailing? For some time now, many in the Coalition and industry have wondered why DDMAC, the OIG, the Department of Justice and various state Attorneys General and consumer fraud units – in their haste to attack industry communications and marketing – have failed to apply the same standards to detailing efforts and communications by health plans and academic detailing organizations. Surely these organizations’ goals and plans to promote particular products raise the very same issues and practices concerning kickbacks and off-label promotion that the government has so eagerly attacked when the industry is involved. One would think that bonuses paid by health plans to physicians to prescribe certain products come under the broad government definition of “kickbacks.”

This scenario raises a number of questions. Wouldn’t it be interesting to see the terms under which academic detailing organizations offer their services to hospitals and universities? Is payment tied in any way to healthcare professional prescribing of “detailed” products? Are bonuses available? How does one determine if academic detailers have met their contractual goals? Whatever happened to transparency when it is not directed to the healthcare industry? And why the silence on the part of DDMAC and other government agencies? DDMAC proclaims its “Bad Ad” program is working to catch supposedly improper industry marketing, but why isn’t it directed at others who violate the rules, promote off label or make unsubstantiated claims? The two articles listed below look at some of these issues. Will the government remain silent?

To link to the RPM Report article, “A Word to the Wise as Managed Care Enters Rx Communications,” click here.

To link to the Washington Legal Foundation article, “A FEDERAL UNSALES FORCE?: ‘Academic Detailing’ on Medical Treatments and the Oversight Imperative,” click here.

Please comment here on this compelling issue.

Sorrell v. IMS: What Marketing Professionals Need to Know

By John Kamp, Executive Director, Coalition for Healthcare Communication

July 18, 2011 — For those who have not read the entire June 23 Sorrell v. IMS Health Inc. Supreme Court decision (No. 10-779), here is a quick summary of what happened and what drug marketing executives need to know.

Top line, the Supreme Court majority not only affirmed the commercial speech rights of pharmaceutical companies to buy and use prescription data for marketing, it also protected the rights of data companies to compile, analyze, publish and sell those data in the increasingly data-driven digital environment.

The Supreme Court also appears to have raised First Amendment scrutiny applied to government restrictions on virtually all truthful marketing activities. Indeed, the Court applied “heightened scrutiny” in this case, apparently expanding the traditional protections for “commercial speech” under the Central Hudson test used for the past 20 years. Moreover, the 6-3 decision logically applies to all marketing, not just medical marketing, strengthening our alliances with consumer marketers and media, including digital media.

For those not familiar with the case, IMS and others challenged a Vermont ban on the marketing use of prescriber data by drug companies. At the same time, Vermont had allowed these data to be used for “counter-detailing” by insurers, managed care and the state. The Supreme Court said Vermont illegally limited speech because it did not like the speaker nor the message and especially because the marketing was effective, i.e., presumably increasing prescription rates for branded drugs.

Vermont said the rules were designed to save money by increasing the use of generic drugs and to protect doctor privacy by protecting them from unwanted sales tactics. The Court said there were non-speech ways to save money and that the protection of doctor privacy was nominal given that others could use the data in marketing.

The Court’s decision may strengthen significantly the position of the Coalition and our industry partners in Washington as we resist legislation and rules banning or restricting marketing. Indeed, the Supreme Court decision calls into question many of the FDA’s restrictions on truthful company speech, especially truthful “off-label” statements by drug sponsors. Drug marketing remains the most prominent heavily regulated topic in advertising, but has not been routinely subject to rigorous regulator restraint or judicial scrutiny. That could change.

Supreme Court Decision Highlights:

(1) Government restrictions based on commercial content and industry speakers were subjected to “heightened” First Amendment scrutiny, much like that traditionally applied to political or so-called “pure speech.” The only clear difference apparent in this decision between “pure speech” and commercial speech that is false or misleading commercial speech is not protected by the First Amendment.

(2) Data and data analytics are also treated as speech protected by the First Amendment. This includes data companies of all types, plus publishers and users of these data.

(3) Marketing restrictions and marketing bans were treated similarly, limiting indirect as well as direct restrictions on marketing communications and making it harder for law makers and regulators to suppress or ban marketing one restriction at a time. 

(4) Government attempts to save money and to protect individual privacy remain potent reasons to regulate speech, but governments cannot just assert these as justifications. Applying traditional First Amendment rules for “pure speech” as well as commercial speech, the Court reasserted that governments must ensure that such rules are narrowly written to avoid burdening speech, and must achieve the legitimate purposes of the law. Additionally, governments must first consider and use non-speech restrictions when possible.

(5) FDA lawyers must be concerned about the continued viability of many of its marketing polices, especially restrictions on truthful “off-label” communications by drug sponsors. Although industry seldom challenges these restrictions, a group of companies recently filed a Citizen’s Petition seeking “clarity” on these rules. This could be a significant step forward. Watch this Website for more background and analysis on this Petition.

(6) Narrow restrictions based on drug safety, such as REMS requirements, were not at issue here. Although subject to First Amendment scrutiny, legitimate safety restrictions are less likely to fail.

Bottom Lines

As a result of this Supreme Court decision, clients, publishers and agencies are in a much better position today to oppose restrictions on marketing and marketing analytics when imposed by all governments, including states, the Congress, the FTC and the FDA.

This case also underlines the value of medical industry alliances with consumer marketers and media publishers, as well as with vendors and other allies. The broad language in this decision arguably applies to all marketers and supports our joint activities with a wide range of allies, including the AAAA, the Internet Advertising Bureau, the Ad Coalition, the Digital Advertising Alliance and the new Digital Health Coalition.

Moreover, the decision enables us to use the First Amendment to defend innovative and effective marketing of all types, including in the digital space where data and data analytics promise to power effective and efficient messaging. While we still must respect reasonable expectations of privacy, the decision will help us resist proposals for broad versions of “Do Not Track” and other limits on digital professional and consumer communication.

However, it is important to remember that opponents of medical marketing are undaunted, very well funded, and remain darlings of the press. These groups will be visible, litigious and smart. Although we had our day and court and won, related policy and legal challenges battles will arise soon.

 

Guest Commentary: Straight talk about Competence v. “Conflict of Interest”

Peter Pitts, former supervisor for the Advisory Committee process at FDA, speaks plainly about the current  Insanity over Conflict of Interest

Sometimes Sanity

By Peter Pitts  

 During my tenure at the FDA I was the senior official in charge of advisory committee oversight and the final decision-maker on who got a COI waiver and who did not. Many did not — but those who did received their waivers because FDA professional career staff made a strong case that these people weren’t just important to the advisory committee — but critical.   And we should all pay attention to the nomenclature.  It’s not about “conflict of interest” – it’s about (as Secretary Sebelius correctly says) “interest.”  And having an “interest” is not necessarily a bad thing – as long as you’re transparent about it.

If we allow FDA adcomms to become the realm of the second best and the almost brightest –what have we done to the advancement of America’s health? The answer is a significant disservice.

In the February 7, 2010 edition of The Lancet, Richard Horton points out that the battle lines being drawn and between clinician, medical research and the pharmaceutical industry are artificial at best — and dangerous at worst.  Dangerous, because all three constituencies are working towards the same goal — improved patient outcomes.

Horton’s main point is that we must dismantle the battlements and embrace of philosophy of “symbiosis not schism.”  It’s what’s in the best interest of the patient.

And so it is with this in mind that I share some promising news (as reported today in The Hill.)

GOP wants FDA bill to boost drug industry’s role

Republicans want to roll back new conflict-of-interest rules they say are depriving the Food and Drug Administration of needed expertise from the drug industry.

Democrats, meanwhile, will focus largely on the safety of imported drugs as Congress begins work on a five-year FDA reauthorization bill.

Congress tightened the FDA’s conflict-of-interest rules in 2007, as part of the last FDA reauthorization. But Republicans on the House Energy and Commerce Committee said they may try to loosen the standards in the next reauthorization, which needs to pass next year.

Committee Chairman Fred Upton (R-Mich.) said the upcoming bill should reverse “rigid, unrealistic conflict-of-interest provisions” that have delayed drug approvals. The rules govern who can participate in FDA advisory panels, which study safety and effectiveness issues.

“No longer can we afford to sideline experts simply because of their ties to the pharmaceutical industry,” Rep. Phil Gingrey (R-Ga.) said Thursday at an Energy and Commerce health subcommittee hearing.

Janet Woodcock, the director of FDA’s drug center, said the limits have slowed down the advisory committee process. The agency sometimes goes through the long haul of finding experts in a given field only to discover ties to the pharmaceutical industry toward the end of the process, she said.

The FDA has already begun negotiating with drugmakers and consumer advocates over the reauthorization bill. Thursday’s hearing marked the first formal involvement from Congress.

Technically, the purpose of the FDA bill is to reauthorize the programs through which drug and medical device companies pay the FDA to review their products for approval. But because it’s a must-pass measure — the people and offices that approve new products are paid for almost entirely by industry fees — it consistently becomes a magnet for broader policy changes.

Upton said Thursday that he also wants to reexamine a piece of the last reauthorization that gave the FDA more power to regulate drugs after they’ve been approved. The FDA can now require drugmakers to study certain safety issues and add new warnings to drug labels.

Upton and other committee Republicans say FDA overregulation is stifling innovation and preventing drug and device companies from creating new jobs. Rep. Henry Waxman (D-Calif.) argued that while getting new products to market is important, the FDA’s mission should be protecting public health rather than fostering job creation.

Energy and Commerce Democrats indicated that the safety of imported drugs will be their biggest policy focus. Rep. John Dingell (D-Mich.) began working on an import safety bill in 2007, the food-safety portion of which passed on its own in 2009.

The FDA inspects foreign factories far less often than domestic ones, and it can’t make a surprise visit outside of the United States. Those limitations received extra scrutiny following the 2007 heparin contamination, which Dingell cited repeatedly at Thursday’s hearing.

Kamp Column: Industry Must Embrace Internet and Social Media or Become Irrelevant in Many Health Conversations

By John Kamp, Executive Director, Coalition for Healthcare Communication

June 29, 2011 — Yesterday I had the pleasure of moderating a lively panel discussion at the 2011 BIO annual meeting in D.C., titled: “Talking About Your Product in the New Age: Social Media and the Internet.” While every speaker recognized the regulatory uncertainty and complexity of Internet marketing, all also agreed that industry must engage patients, caregivers and providers on the Internet or risk becoming irrelevant in many of the most important health conversations.

As regulators at FDA, FTC and Congress contemplate additional rules, consumers and healthcare professionals are consuming information on the Internet with increasing speed. Our industry knows the most about the safe and effective use of its products. Although we must follow existing rules and be prepared for new ones, we also need to offer our first-line expertise wherever our customers seek it.  If industry leads responsibly, government will follow.

We have a long way to go. Yesterday, Coalition board member Michael Myers, President of Palio (InVentiv), most effectively drove home the message in his closing presentation. Using just three examples – Facebook, YouTube and Twitter – he presented data showing that pharma is way behind other brands on social media outreach. His most effective tool was a YouTube video by Erik Qualman, author of socialnomics: how social media transforms the way we live and do business (http://www.youtube.com/watch?v=x0EnhXn5boM). This four-minute video “says it all,” according to Myers.

To tease you into downloading it, here are just a few tidbits:

  • Social media is “word of mouth … on steroids”
  • 90 percent of consumers trust peer recommendations
  • Just 14 percent of consumers trust ads
  • 93 percent of marketers use social media for business

For Facebook, YouTube and Twitter, Myers showed the amazing growth in consumer and marketing use, including examples of outstanding pharma sites. While we all know Facebook use is extensive, Myers stated that consumers spend more than 700 billion minutes per month on Facebook. And, although many pharma brands have pages – even as Facebook is limiting control – the average pharmaceutical Facebook page analyzed had roughly 13,000 fans compared to the millions of Starbucks fans, noted Myers.

Meanwhile, YouTube serves as a medium to push and share a large amount of content, Myers said, and is second to Google as a search engine. It has the highest number of page views on any social media site; the average YouTube user is between the ages of 18 and 54 and 70 percent of traffic comes from outside of the United States. Pharma YouTube accounts have relatively few subscribers and channel views, he noted. Also, the average pharmaceutical Twitter page that Myers analyzed had roughly 1,800 followers.

Summarizing, Myers says better use of social media will be integral to a company’s future success, adding that the return on investment of social media “is your business will still exist in five years.” 

Notwithstanding these facts, many in industry have been waiting for the FDA’s impending draft guidance on social media before moving forward aggressively. According to DDMAC head Tom Abrams at the DIA annual meeting two weeks ago, FDA at last may be close to issuing the first of those guidances. But we’ve heard that before, and remember, Abrams also has stated repeatedly that these guidances will not make any new FDA policy, just “clarify” existing policy for the new media.

Study after study confirms that consumers are not waiting for the FDA and the FTC to establish their Internet rules before seeking health information online. For example, a recent Pew Internet Project/California HealthCare Foundation survey found that 66 percent of consumers look online for information about a specific disease or medical problem. And, doctors and other health providers are ahead of consumers in terms of their Internet use.

Meanwhile, a study supported by PhRMA found that a majority of physicians believe that industry’s detail forces provide valuable patient information. Industry needs to be on the Internet, on iPads and Blackberrys, and on desktop screens, regardless of institutional, social and regulatory barriers.

At present the industry is using various strategies to cope with existing barriers. Many companies only host social media sites about relevant disease states – avoiding branded drug sites to steer clear of off-label and adverse event issues. Where companies host branded sites, the company’s insistence that only on-label uses be discussed can confuse and sometimes anger site visitors who do not understand the FDA constraints.

Another challenge for companies is providing FDA-required safety information in space-restricted media. One solution not yet addressed by the FDA is an industry proposal to allow the use of a universal symbol for sites that feature FDA-regulated benefit and risk information. This proposal would point users to reliable information vetted by the FDA, helping patients to cull the good from the bad among information providers.

Companies also must heed the FTC’s privacy policies and its increasing warnings about social media and digital marketing. The FTC is actively enforcing social media infractions and may receive additional authority to regulate online behavioral advertising – including the possibility of establishing a mandatory “Do Not Track” mechanism – if pending bills in the House and Senate become law.

The Coalition and others oppose mandatory Do Not Track provisions and believe that consumer privacy and robust Internet commerce is better served by self-regulation. The new Digital Advertising Alliance has created the icon shown here to enable easy consumer opt-outs of unwanted tracking and marketing. For more information visit:  www.AboutAds.info

Pitts: BIO’s Call for Drastic Regulatory Change Is On Point

Pitts: BIO’s Call for Drastic Regulatory Change Is On Point

June 27, 2011 — In a recent blog entry on DrugWonks.com, Peter Pitts commended BIO’s proposals to revamp the U.S. regulatory system for new treatments and therapies. Pitts mentions that BIO’s plans, as reported in BioCentury, include a progressive approval pathway for unmet condition therapies, a fixed term for the Commissioner of Food and Drugs, a redefinition of FDA’s mission and the FDA as an independent agency, separate from the Department of Health & Human Services.

Read more on the DrugWonks.com Web site

Ad Coalition: Online DTC Studies Should Not Further Delay FDA Social Media Guidance

June 27, 2011 — The Food and Drug Administration (FDA) should move forward with its social media/Internet guidance and not wait for the results of the three studies it recently announced it would conduct to test benefit and risk information presentations on direct-to-consumer (DTC) prescription drug Web sites, according to comments submitted to the FDA today by The Advertising Coalition in response to an April 28 Federal Register notice.

“Patients, health care providers and the industry need the FDA to provide Internet and social media guidance as soon as possible,” said John Kamp, executive director of the Coalition for Healthcare Communication (CHC). “Good research is always valuable, but guidance is what is needed right now.”

Accordingly, the comments state, “The [Advertising] Coalition encourages the FDA in the strongest possible terms to proceed with the issuance of draft guidance even as the proposed consumer surveys are undertaken.”

The comments also note that because online media are volatile, what the FDA learns about consumer preferences or comprehension today might no longer apply in the near future, that a lack of guidance may be stifling DTC outreach and that the FDA should address the permissibility of hyperlinks to provide risk information in the forthcoming draft guidance.

The Advertising Coalition represents U.S. advertisers, ad agencies, media and media-related companies engaged in the development and dissemination of DTC prescription drug advertising. The CHC participates in The Advertising Coalition through the American Association of Advertising Agencies (4As).

Industry Needs Guidance Now

The Advertising Coalition’s comments state that although the FDA may seek additional evidence to support its guidance, the agency already has enough information to develop new media guidance. Further, the Coalition asserts that the results of these FDA studies will represent only a snapshot of consumer input in an ever-changing online environment.

“Certainty is an elusive goal, particularly when it comes to studying the effects of particular executional techniques in dynamic new media that are evolving rapidly in real time,” according to The Advertising Coalition. If the agency issues guidance now, “there is surely no legal impediment to the agency’s modification of the draft guidance at a later date,” the comments state.

“The uptake of the new media by patients, caregivers and professionals is simply astounding,” added Kamp. “Industry must participate to ensure that quality information is available. FDA guidance would reduce regulatory risk and support wider industry participation,” he said.

In the wake of ongoing delays from the FDA regarding this guidance, DTC advertisers are left tracking ad hoc agency enforcement actions – Notices of Violation and Warning Letters – to determine what is and is not permissible DTC Internet promotion, a situation that can hinder the positive benefits of DTC promotion.

“While regulation through enforcement may have in terrorem effects that FDA perceives as beneficial, this approach has a correspondingly serious, chilling effect on protected speech, such as DTC communications, that FDA has acknowledged may be of high public health value,” the comments state.

Fair Balance Should Be Determined by ‘Net Impression’

The Advertising Coalition also objects to the FDA’s current enforcement position that hyperlinks are not an appropriate mechanism to provide risk information in online DTC marketing. Arnold I. Friede, Arnold I. Friede & Associates, who authored The Advertising Coalition’s comments, previously told CHC that the FDA’s “categorical rejection” of the use of hyperlinks to provide risk information is “inconsistent with the approach FDA has taken in other analogous contexts.” 

Quoting a 2009 FDA guidance, the Coalition’s comments state that the FDA at that time acknowledged the need for contextualizing both risk and benefit information. “This proposition that risk communication be evaluated based on overall ‘net impression’ and what ‘the piece as a whole conveys’ is congruent with the notion that conspicuously hyperlinked risk information, depending on context, is as much part and parcel of an advertising execution as any information that appears on the face of the promotional piece itself,” according to the comments.

The comments also reference a U.S. Supreme Court case (Kordel v. United States) discussion which states that depending on context, one piece of information can accompany another and be deemed labeling without physical attachment between the two.

Additionally, The Advertising Coalition points out in its comments that the FDA should take into account the limitations of using traditional research techniques to better understand multi-faceted and fast-changing media. By the time the research results are available, the comments state, “it is virtually certain that the media being studied will have changed in ways not envisioned in the research.”

NEWS ALERT: U.S. Supreme Court Deems Vermont Marketing Ban To Be in Violation of First Amendment

June 23, 2011 — In a victory for data gathering companies, the pharmaceutical and biotechnology industries, advertising agencies, medical publishers and other media, the U.S. Supreme Court ruled in Sorrell v. IMS Health Inc. today that Vermont’s ban on marketing use of prescription data “turns on nothing more than a difference of opinion” and that the state’s justifications for imposing “content- and speaker-based burdens on protected expression” do not withstand “heightened scrutiny.”

The Supreme Court’s 6-3 decision in favor of IMS (No. 10-779), followed oral arguments presented April 26, during which the Justices signaled that Vermont’s law was an attempt by the state to manipulate the “marketplace of ideas” on behalf of ideas favored by the state while restricting the rights of pharmaceutical companies to target doctors with truthful messages.

“This is a victory for patients as well as industry,” said John Kamp, executive director of the Coalition for Healthcare Communication. “Although couched in terms of privacy and cost reduction, the Vermont law was a transparent attempt to censor industry speakers while enabling government and others to speak. Enlightened policy makers always knew it was a bad idea. Now, it’s clear that the ban is also a violation of the First Amendment,” he said.

“Patients are not served by censorship. Without good data, no one can make informed decisions, including doctors, patients, policy makers and industry,” Kamp continued. “This and similar state statutes were direct attacks on data gathering, analytics and use. Let’s hope the proponents of these statutes find better ways to advance their policy goals.”

Indeed, the Supreme Court’s opinion states that Vermont “may not burden protected expression in order to tilt public debate in a preferred direction.”

Entities that either joined or supported IMS in this case also are pleased with the outcome. “We have long maintained that Vermont’s prescriber data restriction law – and others like it – violate the U.S. Constitution by restricting speech in two ways: by limiting the transmission of factual and accurate information about prescribing practices; and also by limiting marketing that utilizes that information said Cathy Betz, vice president, Government Affairs, Wolters Kluwer.

“Moreover, these types of laws do nothing to improve healthcare, reduce costs or protect physician/patient privacy as proponents have claimed,” Betz noted. “Today’s ruling is a very important decision for commercial speech in general. The Court invalidated most any attempt to put limits on commercial free speech in advertising and marketing.”

Christopher A. Mohr, an attorney with Meyer, Klipper & Mohr PLLC, and counsel of record for the amicus brief filed in support of IMS by the Coalition, American Business Media, The Consumer Data Industry Association, CoreLogic, The National Association of Professional Background Screeners, and Reed Elsevier Inc. offered the following comment on the Supreme Court’s opinion.

“Today, the Court re-affirmed several basic First Amendment principles and their application to the database industry. First, it rejected any suggestion that the aggregation of information into a database renders it a commodity or ‘beef jerky.’  Databases (and the publication of the information within them) are unequivocally protected by the First Amendment,” Mohr said.

“Second, the case makes clear that the government cannot prevent the dissemination of accurate information (as it tried to in this case) by discriminating against particular speakers speaking on particular subjects.  This case involved pharmaceutical information, but its implications reached far broader than that. The opinion not only protects the rights of information publishers to make information available on a variety of subjects without government interference, but also ensures that the public may receive relevant information to make better business, economic and political decisions,” he said.

The Coalition will continue to offer ongoing analysis of this decision.

Former FDA Policy Chief Says Consumer Group Request Would Slow Drug Approvals

June 16, 2011 – The Food and Drug Administration (FDA) should not mandate comparative effectiveness trials as part of the drug approval process, according to Scott Gottleib, a resident fellow with the American Enterprise Institute for Public Policy Research (AEI).

Gottleib, a former FDA policy head, writes in AEI’s June issue of Health Policy Outlook that the FDA should not bow to the pressure of consumer groups that are calling for across-the-board comparative effectiveness trials be added to the drug approval process, noting that these trials already are being conducted in important cases. Requiring these trials for all drugs would significantly slow down drug approval reviews, he asserts in the article. Read the full AEI Guest Column.

FDA Declares Victory in Year One of “Bad Ad” Program, But Some Industry Insiders Are Not So Sure

June 14, 2011 — The FDA proclaimed success for the first year of the “Bad Ad” program, through which healthcare professionals are asked to report suspected untruthful or misleading drug promotion to the Division of Drug Marketing, Advertising, and Communications (DDMAC). The program is so successful, says DDMAC leaders, it will be expanded, “based on the overwhelmingly positive feedback and response from the medical community.”

However, some industry lawyers are not so sure. For example, Arnold Friede, who has experience both in the FDA General Counsel’s office and at Pfizer, and who is now in private practice, said this on an industry blog: “I think the news here isn’t so much about what FDA has heard from doctors or about how many letters FDA has sent, but about the in terrorem impact of the Bad Ad program. This program gives companies yet another reason to monitor their promotional behavior,” Friede said. “The FDA is deputizing doctors to become informants. It’s like the old ‘Deputy Dawg’ show, except it’s ‘Deputy Doc.’”

Interestingly, the agency states in the report that the sheer volume of reports is not how it will measure the success of the program. Instead, “FDA’s most important measure of success for this program is the heightened sense of awareness of misleading promotion among HCPs throughout the health care community and the likely useful deterrent this awareness has on drug promoters who might run afoul of regulation absent such messaging.”

Program Expansion Plans

In an annual report released yesterday, entitled “Bad Ad Program: 2010-11 Year End Report,” the FDA states that it “expects to continue and expand its Bad Ad efforts in the coming years.” Expansion activities will include the development of a Web-based continuing education program, a focus on students and early-career health care professionals and the active pursuit of opportunities to collaborate with the nation’s medical, pharmacy and nursing schools to enhance student education, according to the report.

Healthcare marketers also should be aware that DDMAC representatives will continue to attend industry events, including this roster of trade shows:

  • American Academy of Physician Assistants
  • American Academy of Nurse Practitioners
  • American Academy of Family Physicians
  • American Academy of Pediatrics
  • American College of Gastroenterology
  • American Society of Health System Pharmacists

At an FDA Webinar in April, Catherine Gray, DDMAC management advisor, said that although DDMAC is charged with regulating print, broadcast and oral communications made by or on behalf of prescription drug companies, it cannot possibly “be in every discussion with every sales rep,” so it is asking healthcare providers to use the agency’s “Bad Ad” initiative to report any marketing activities that could potentially be in violation of FDA marketing rules.

Year One Results

During its first year, the Bad Ad program yielded 328 reports of questionable marketing. Of those, 188 were sent in by healthcare professionals, 116 were sent in by consumers and 24 were submitted by industry competitors; only 4 percent of reports were submitted anonymously. Five Warning Letters were issued by the FDA as a result of these reports.

Legal Guide Spells Out Social Media’s Risks, Benefits

June 9, 2011 — A new White Paper by the law firm Reed Smith demonstrates that the perils of social media go well beyond waiting for guidance from the FDA. The guide, free to employees of 4As agencies and other supporters of the Coalition for Healthcare Communication, can be downloaded using the link below.

“Okay, so it may be more than you ever wanted to know,” said Coalition Executive Director John Kamp. “Download it anyway, scan it, and keep it handy when the inevitable questions arise. If you don’t have a company policy, use this White Paper to help you create one now to avoid trouble for you and your clients.”

“Network Interference: A Legal Guide to the Commercial Risks and Rewards of the Social Media Phenomenon” does not focus on FDA regulation but on the broader array of  legal matters that might arise with advertising and marketing; commercial litigation; data privacy and security; employment practices; government contracts and investigations; insurance recovery, litigation, evidence and privilege; product liability; securities; and trademarks.

The White Paper’s introduction warns that what used to be discussed or communicated in private now is often public, with “All of it memorialized in discoverable form. All of it available to millions with the simple press of ‘post.’”

In the advertising and marketing chapter, Reed Smith authors note that while there are many benefits to social media communications, “it’s critical to understand and navigate the legal minefields that are both dynamic and evolving as the media evolves.” Topics in this section include brand awareness (branded pages, promotions and contests) and brand interaction (bloggers, customer service/feedback, user-generated content), as well as talent compensation.

In this chapter’s “Bottom Line—What You Need to Do” sidebar, the authors state that regardless of the level of a company’s social media participation, all companies should have policies in place and that every employee should understand them. Among other uses, the policy should enable companies and their clients to “be prepared to respond to negative comments made about the company and/or its brands.”

Download the full Social Media Legal Guide here.

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