Catania's Bill Would Regulate Pharmaceutical Salespeople

About 3,000 to 4,000 sales representatives work in the D.C. region and cast a wide net outside the area, Powell said. "They typically work in D.C. and in Maryland and Virginia, Delaware and Pennsylvania. Should they be licensed in all of those jurisdictions?" she asked. "It's going to be a fairly huge administrative process."

She said that the average sales representative receives training two to three times a year and "typically has a background in science, medicine or pharmacy."

Catania said federal agencies do not have the resources to closely monitor the multibillion-dollar trade. "If we put a chink in that armor, I think it will shake the pharmaceutical industry to its core," he said. "This is about patient safety, having decisions made based on science and efficacy, not money."

Catania and advocates of the bill say patients' health can be threatened by salespeople who provide false information about prescription drugs.

Catania, chairman of the council's health committee, has been lobbying colleagues for support, pushing the bill out of committee with a 3 to 2 vote and altering it to accommodate concerns. But pharmaceutical lobbyists have been right on his heels, enlisting David Wilmot, a local lawyer who knows the political landscape.

Wilmot and some council members, including Marion Barry (D-Ward 8), have questioned whether Catania's bill would really protect patients or whether it is a pet project for the lawmaker, who was recently elected chairman of the National Legislative Association on Prescription Drug Prices. Formed in 2000, the group of state legislators is building a reputation for taking on the pharmaceutical industry.

The debate is open on the 13-member council, with no majority on either side of the issue. Although both have claimed the support of Muriel Bowser (D-Ward 4), she said she is undecided. "I'm waiting to see some amendments," she said.

The problem with the legislation, some council members have said, is that it is several bills in one -- and they have to agree with each part to pass it.

Barry, one of the dissenting voters on the health committee, said he doubts the bill would have any effect on the city's status as having some of the highest rates of several chronic diseases in the nation. "We've got the biggest AIDS epidemic in the country," he said. "Spend time working on that."

Barry is particularly critical of the legislation's licensing rules. "If you regulate detailers, so what?" he asked. "The doctors don't need to be protected from detailers."

Christopher McCoy disagrees. McCoy, a physician in internal medicine in Minnesota, is a member of the prescription privacy committee of the National Physicians Alliance. The group of doctors, formed two years ago, does not accept money from pharmaceutical companies.

There has been controversy recently over doctors receiving money from drug companies for speaking engagements and other activities, which critics say influences doctors' prescription choices.

"Our self-confidence makes us believe we are immune to marketing," McCoy said. "Why would the drug companies spend $12 billion if it didn't work?"

The industry actually spends an average of $25 billion a year on marketing, and 60 percent of that is for pharmaceutical samples, Powell said. Last year, it also spent $55.2 billion on research and development of new medicines, she said.

McCoy said his group is most worried about data mining. "They have more information than we do. Most doctors I talk to are offended by this," he said.

A U.S. District judge blocked New Hampshire this year from enforcing its law prohibiting data mining on the grounds that it restricts commercial free speech. State Rep. Cindy Rosenwald (D) said the state is appealing.

"There's no question that using doctors' prescriptions to fine-tune your marketing plan has an impact on drug sales," she said. "There's no other industry that has such detailed information of their customers without their permission."

Powell said data mining has benefits for patients because sales representatives can learn more about which drugs doctors are prescribing and better inform them of their effects.