Bill Summary for Bill Number SB09-166

Date: 02/18/2009

Final
BILL SUMMARY for SB09-166

SENATE COMMITTEE ON BUSINESS, LABOR AND TECHNOLOGY

Votes: View-->	Action Taken:
Moved a conceptual amendment to match the gift ban Moved prepared Amendment L.002 (Attachment E). Th Moved to postpone Senate Bill 09-166 indefinitely Moved to refer Senate Bill 09-166, as amended, to	TIE Pass Without Objection PASS FAIL

04:43 PM -- Senate Bill 09-166

Senator Carroll presented Senate Bill 09-166. The bill establishes the Prescription Drug Ethics Act. It prohibits a drug, biological product, or medical device manufacturer who participates in a state health program from giving health care practitioners any economic benefit. Exemptions are made for payments for conferences, honoraria, and product samples. The bill requires manufacturers to disclose certain information to the State Board of Pharmacy. Senator Carroll explained her reasons for sponsoring the bill. She discussed problems with the current health care system and the state's role in fixing them. She described the bill's gift ban and its relation to pending federal legislation. She spoke about the importance of transparency and the privacy of medical records. She discussed legislation in other states that prohibits "data mining." She discussed issues that the bill does not address. She stated that doing nothing would hurt the state's economy.

04:55 PM

Senator Mitchell questioned Senator Carroll about the bill. He addressed her argument that over half of states have looked at some part of what her bill does. He asked if any state had passed what she is proposing. Discussion continued, and Senator Carroll described data that would support the bill.

The following individuals testified:

05:03 PM -- Robert Hunkler, representing Intercontinental Marketing Services (IMS) Health, testified in opposition to the bill. Mr. Hunkler described IMS Health and its reasons for opposing the bill. He discussed a packet of documents that had been distributed to the committee (Attachment A). He discussed the volume of prescription drugs written in Colorado in the previous year. He stated that on a national basis, the use of branded drugs is declining. He noted that only 1.3 percent of drugs prescribed in the previous year were branded drugs that were on the market for three years or less, and that restricting prescription drug information will not reduce health care costs. He responded to questions from Senator Heath regarding trends in the prescription of generic drugs.

05:13 PM -- Steve Palmer, representing IMS Health, offered to answer committee questions. Mr. Hunkler responded to questions from Senator Foster regarding whether he would support the bill if it were amended.

05:14 PM -- John Collar, representing Colorado BioScience, testified in opposition to the bill. He distributed a packet of materials to the committee (Attachment B). He discussed the economic impact the bill would have on the bioscience industry. He described problems with the language of the bill.

05:21 PM -- Dr. Timothy Rodell, representing GlobeImmune, testified in opposition to the bill. He described his Colorado-based biotech company and his experience in health care companies. He stated that he supported the sentiment and intent behind the bill, but said that the bill would not accomplish its goals and would have very serious unintended consequences. He noted that the bill duplicates protections already in place. He stated that the prohibition against gifts is impractical and would result in a loss of convention business. He responded to questions from Senator Mitchell regarding the impact the bill would have on his company's ability to conduct clinical studies. Discussion continued between Dr. Rodell, Senator Mitchell, and Senator Carroll.

05:29 PM -- Jack Wheeler, representing MicroPhage, testified in opposition to the bill. He described his company and discussed how the bill would affect its ability to operate. Senator Foster asked Senator Carroll a question regarding her intent with the bill's gift ban. Senator Carroll discussed the exemptions contained in the bill and described her intent regarding data. Discussion continued between Mr. Wheeler, Senator Carroll, and Senator Foster.

05:36 PM -- Tara Ryan and Khalil Nuri, representing the Pharmaceutical Research and Manufacturers of America (PhRMA), testified in opposition to the bill. Ms. Ryan discussed data concerning the pharmaceutical industry and cited data indicating that marketing practices do not influence doctors' prescriptions. She discussed the consequences of the bill. She discussed other regulations and federal oversight pertaining to pharmaceutical companies.

05:46 PM

Mr. Nuri discussed existing regulations for pharmaceutical companies. He stated that the bill may increase marketing costs because manufacturers will not be able to target specific prescribers. He noted that because physicians already have the ability to opt out of marketing operations, the bill is duplicative and unnecessary. He shared a personal anecdote related to the ability of manufacturers to target specific prescribers. Senator Mitchell said that the bill does not protect privacy, but only bars information that could be used for marketing purposes. He stated that accurate medical information about the conditions that a provider is treating would facilitate appropriate marketing operations. Discussion continued among Mr. Nuri, Ms. Ryan, and the members of the committee.

05:52 PM -- Tom Tremble, representing the Advanced Medical Technology Association, testified in opposition to the bill. He described his association and its concerns with the bill. He discussed federal legislation that the association supports. Senator Scheffel asked if Mr. Tremble's association would be considered a "gifter," and Mr. Tremble explained his association's code of ethics. Discussion continued. Senator Carroll made comments addressing Senator Scheffel's question.

05:59 PM -- Dr. Ned Cosgriff, a medical officer representing Covidien, testified in opposition to the bill. He discussed his company and its concerns with the bill. He stated that national disclosure requirements and the company's existing code of ethics provided any protection necessary. Responding to a question from Senator Heath, Dr. Cosgriff stated that collaborative relationships within the industry are necessary.

06:06 PM -- Chris Lepore, the Director of State Government Affairs for Johnson & Johnson, testified in opposition to the bill. He stated that the bill would have a negative effect on research and development in Colorado. He noted that the bill is similar to legislation passed in Massachusetts and discussed the chilling effect that legislation has had on clinical trials conducted there. He discussed other concerns with the bill. He described the use of prescriber data to maximize resources and to reduce costs and meeting times.

06:14 PM -- Rob Clark, representing Medtronic Inc., distributed written testimony to the committee (Attachment C).

06:16 PM -- Dr. Kiki Traylor, representing Amgen and herself, testified in opposition to the bill. She discussed recent updates to the pharmaceutical code concerning gift bans and stated that companies were complying. She noted that the University of Colorado had already passed a policy banning conflicts of interest. She stated that time was needed to see if the policies would work. She added that competition is necessary to fuel innovation. She described the ability of individuals to opt out of prescriber data programs and discussed the overlap between research and marketing. She stated that the bill could prohibit companies from coming to Colorado. Senator Mitchell asked Dr. Traylor to address the bill's premise that a doctor's professional judgment could be distorted by marketing practices. Dr. Traylor discussed various studies pertaining to Senator Mitchell's question and stated that she finds it offensive that her ability to use good judgment is not respected.

06:23 PM -- Holli Baumunk, the Vice President of the Metro Denver Economic Development Corporation and an affiliate with the Denver Metro Chamber of Commerce, testified in opposition to the bill. She discussed the effect the bill would have on Colorado's bioscience industry.

06:26 PM -- Eric Morgan, representing Roche Pharmaceuticals and Roche Colorado, testified in opposition to the bill. He described his company and its economic impact on Colorado. He discussed his company's concerns with the bill. He responded to questions from Senator Heath.

06:30 PM -- Susan Cox and Anthony Barrueta, representing Kaiser Permanente, testified in favor of the bill. Mr. Barrueta made comments about the bill. He discussed the closed system in Kaiser and stated that the protections available there should be available to all. Ms. Cox clarified certain marketing operations. Mr. Barrueta discussed studies concerning the effect of educational materials when accompanied by a meal. He said that the primary role to regulate professions lies with the state.

06:41 PM

Responding to questions from Senator Mitchell, Mr. Barrueta discussed legislation in other states. Senator Heath asked for clarification as to why Kaiser Permanente would support limitations on the marketing of drugs. Mr. Barrueta stated that there are better ways to educate physicians about drugs other than through direct marketing.

06:56 PM -- Dr. Mark Earnest, representing himself, testified regarding the bill. He stated that conflicts of interest in prescribing are pervasive and ultimately harm patients. He discussed the effects of relationships between doctors and drug companies, and spoke about research papers written by doctors who had conflicts of interest with drug companies. He described the practice of data mining and stated that he finds the practice offensive. He discussed data mining legislation in other states.

07:08 PM

Dr. Earnest responded to questions from Senator Mitchell regarding professionals who would prefer to operate under an academic code rather than state regulations and academics who may unethically promote drugs.

07:12 PM

Senator Foster asked if anything in the bill would diminish the research and development of bioscience. Dr. Earnest responded that it would not and made additional comments.

07:15 PM -- Jacquelyn Kilmer, Vice President of the Colorado AIDS Project, and member of Colorado Organizations Responding to AIDS (CORA), testified in support of the bill on behalf of her organizations. She described the organizations she represents and discussed the health care costs of patients with AIDS. She stated that her organizations respect and appreciate the pharmaceuticals industry, but indicated that the bill represents sound public policy.

07:17 PM -- Dr. Lynn Parry, representing the Colorado Prescription Coalition, testified in favor of the bill. She stated that she was concerned with the cost and safety of health care. She distributed a packet of articles to the committee (Attachment D). She said that aggressive marketing is hazardous to the consumer. She indicated that responsible business practices would still be possible if the bill were passed. Dr. Parry responded to questions from the committee.

07:30 PM -- Jody Reuler, representing the Rocky Mountain Health Care Coalition, was not present to testify. Senator Carroll requested that the record show who he represented and that he supported the bill.

07:31 PM -- Ramnik "Ricky" Dhaliwal, a medical student representing himself, testified in favor of the bill. He described the mission of a physician and his experience with physicians who prescribed drugs due to their relationships with drug companies. He discussed his legal background and its application to the medical profession. He stated that the bill was a pro-consumer bill. He asked the committee to support the bill and requested that the members take the time to read the bill.

07:37 PM

Senator Tochtrop discussed her experience as a registered nurse. She stated that samples provided by drug representatives enabled lower-income patients to obtain medication. Mr. Dhaliwal noted that the bill did not ban samples and stated that only 20 percent of samples being distributed go to lower-income patients. Senator Tochtrop indicated that the language of the bill would make it hard to track samples, leading physicians to stop giving them. Mr. Dhaliwal noted that the portion of the bill she was referring to was an already existing regulation.

07:41 PM -- Bob Semro, representing the Colorado Consumer Health Initiative (CCHI), testified in favor of the bill. He discussed other organizations that support the bill, and Senator Carroll provided additional clarification. Mr. Semro discussed data mining and the money spent on marketing operations.

07:45 PM -- Greg Glischinski, representing the American Association of Retired Persons (AARP), testified in favor of the bill. He stated that the bill would help safeguard patients' private information and would restrict the practice of prescribing a more expensive drug than is required.

07:50 PM

Senator Carroll made closing remarks. She addressed the concerns of the opposition, and noted that the exemptions within the bill address many of those concerns. She discussed data mining and gifts. She said that if the industry has already instituted a gift ban, then it must not think that gift bans will end research and development. She referred to the language of the bill and stated that if it is not clear, then she will make it clear. She stated that it was unfair for consumers to be unable to find out information about drug representatives who access patient data. She discussed pending federal legislation that the industry would accept, and offered to adjust the bill so that it parallels the federal legislation. She addressed the argument that the gift ban would cause jobs to be lost. Members of the committee made comments about the bill.


BILL:	SB09-166
TIME:	08:05:33 PM
MOVED:	Foster
MOTION:	Moved prepared Amendment L.002 (Attachment E). The motion passed without objection.
SECONDED:
		VOTE
	Foster
	Harvey
	Mitchell
	Scheffel
	Tochtrop
	Heath
	Veiga

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB09-166
TIME:	08:13:28 PM
MOVED:	Foster
MOTION:	Moved to refer Senate Bill 09-166, as amended, to the Committee on Appropriations. The motion failed on a 1-6 roll call vote.
SECONDED:
		VOTE
	Foster	Yes
	Harvey	No
	Mitchell	No
	Scheffel	No
	Tochtrop	No
	Heath	No
	Veiga	No

Not Final YES: 1 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: FAIL

08:14 PM

Senator Carroll requested that a member of the committee move a conceptual amendment to amend the portion of the bill concerning gift bans to match pending federal legislation concerning gift bans. The conceptual amendment would affect Section 12-22-903 of the introduced bill. Senator Veiga stated that such a motion would be ruled out of order.


BILL:	SB09-166
TIME:	08:14:06 PM
MOVED:	Foster
MOTION:	Moved a conceptual amendment to match the gift ban portion of the bill, Section 12-22-903, to pending federal legislation concerning gift bans. The motion was ruled out of order by the chair, and no vote was taken.
SECONDED:
		VOTE
	Foster
	Harvey
	Mitchell
	Scheffel
	Tochtrop
	Heath
	Veiga

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: No Vote


BILL:	SB09-166
TIME:	08:16:53 PM
MOVED:	Tochtrop
MOTION:	Moved to postpone Senate Bill 09-166 indefinitely using a reversal of the previous roll call. There was no objection to the use of the reverse roll call, therefore, the motion to postpone Senate Bill 09-166 indefinitely passed on a 6-1 roll call vote.
SECONDED:
		VOTE
	Foster	No
	Harvey	Yes
	Mitchell	Yes
	Scheffel	Yes
	Tochtrop	Yes
	Heath	Yes
	Veiga	Yes

Final YES: 6 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS