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7/17/2002 BOULDER, CO

You thought your medical information was private, right? So did a Florida woman who received an unexpected trial pack of once-a-week Prozac in the mail, writes privacy advocate Jeff Finkelstein. “I found it appalling and frightening to receive free samples of a very powerful medication by mail when I didn’t know the package was coming,” said the woman, identified only as S.K. According to attorney Gary Farmer Jr., the privacy issue comes to the forefront because other people could have access to the package and accompanying literature and deduce the kind of illness the recipient has.

Believe it or not, it’s actually easy to purchase lists of people with any one of 60 ailments, such as diabetes, depression or high blood pressure. The Medical Marketing Service has cross-referenced 16 million households with “ailment” information compiled from 250 to 300 million surveys. You can purchase lists based on age, gender, income, education level, prescription information and type of ailment, and send personalized product information to breast cancer survivors, glaucoma patients or people with high cholesterol.

Drug manufacturers spend many years and hundreds of millions of dollars bringing new medications to market, and deserve to use advertising and marketing to help create awareness of their products and get medication into the hands of people that can benefit from treatment. Yet pharmaceutical companies should place the same care in their sales and marketing systems as they do in the research, development and manufacturing of multibillion-dollar medications.

Pharmaceutical companies need to realize that business success relies on an unbroken chain of consumer trust. When a doctor hands you a pill and tells you that it will make you feel better, you have to place trust in your doctor (that she knows what she’s doing), your pharmacist (that she’s dispensing the right medication and correct dosage), and the manufacturer of the medication (that the pills are safe and effective).

The Food and Drug Administration (FDA) regulates products accounting for 25 cents of every dollar Americans spend, and is in charge of making sure that new drugs introduced by pharmaceutical companies don’t cause harmful side effects like the thalidomide birth defects that plagued the late 1950s and early 1960s. While America’s trust in the federal government has increased ever since the events of September 11, there are only so many inspectors that can watch over the companies that sell $1 trillion in products a year.

It was only after many soldiers reported adverse side effects of the anthrax vaccine to Congressional investigators that the FDA investigated the vaccine’s manufacturer, BioPort. After finding “numerous deficiencies,” the facility was shut down in 1998. In October 2000, the FDA found 18 violations of “manufacturing procedures” at the facility, and in October 2001, the FDA was so concerned they prohibited the company from shipping the anthrax vaccine, despite terrorist-related anthrax attacks.

So you’d think that Prozac manufacturer Eli Lilly would understand that trust begins with respecting the users of their medication. In an effort to convert users of Prozac (the patent expired in 2001) to a new weekly version (with many years of profitable patent protection), Eli Lilly, Walgreens and participating doctors mailed S.K and others free samples. Eli Lilly paid the pharmacy an undisclosed amount each time a prescription was filled. The Florida attorney general’s office is currently investigating whether Lilly violated the state’s unfair trade law and will forward the case to the Florida Board of Medicine.

So why did this direct mail campaign break a fundamental chain of trust? It’s because the data was not permissioned. In the U.S., laws often cover sectors of the economy. Your bank and medical records are held to different standards than the information that is gathered and shared every time you make a purchase out of a catalog or at a grocery store. So when Eli Lilly used information that was supposed to be protected by privacy regulation and legislation, the net result was a large lawsuit against all the parties involved.

How could Eli Lilly have done permission marketing correctly? By getting permission directly from the patient as new information becomes available about their condition. Yet Eli Lilly has had problems with doing even that. In July 2001, Lilly sent out an e-mail newsletter to 669 people who signed up to receive just this kind of permission-based, Prozac-related information via e-mail. But instead of using a professional e-mail marketing solution (or simply using the BCC: line), they simply pasted all 669 people’s e-mail addresses in the TO: line. The people who were already depressed and taking Prozac were even more depressed when they learned their identities had been compromised.

In that case, the Federal Trade Commission (FTC) took action, and Eli Lilly agreed to settle the FTC charges regarding the unauthorized disclosure of sensitive personal information collected from consumers through its Prozac.com Web site. In the most recent direct mail case, S.K. is currently suing her doctors, the Walgreen Company pharmacy chain and drug manufacturer Eli Lilly & Company for invading her privacy and other alleged violations of Florida law.

Wake up, Big Pharma. Applying the non-permissioned direct marketing techniques used by soap companies to get consumers to try new brands simply isn’t appropriate for a medication like Prozac. Marketing a medication to consumers requires the same care and attention that is used to research, test and manufacture the drug. We consumers deserve nothing less.

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