Drug makers spend millions of dollars to develop secret reports about doctors and their patients, including information such as whether a patient is switched over to a competitor’s drug and whether the doctor treats many poor patients and may want free samples.

Pharmaceutical companies spent $19 billion on marketing in 2001, and $16 billion of it was spent on marketing to doctors.

Many doctors are seeing fewer drug sales representatives and limiting their visits when they do, so the reports, or "prescriber profiles," allow sales reps to tailor their pitches to individual physicians.

The profiles allow sales reps to see a doctor’s prescribing habits within days of when the prescription is written, which allows them to see whether a doctor is responding to their pitch. For instance, if a doctor prescribes a competitor’s drug, the rep can focus the pitch on undermining that drug.

Further, drug companies would give gifts and trips to doctors who routinely prescribed their drugs. There are now voluntary industry guidelines in place that discourage such gifts.

Drug companies have been hiring outside firms to purchase data on doctors from pharmacies since the mid-1990s. While the practice is legal in the United States as long as patient names are not revealed, it was outlawed in the Canadian province of British Columbia in 1996.

Many doctors are concerned that the reports allow sales reps to push expensive drugs more effectively in a health care system that is already struggling with increasing costs. However, according to one company that sells prescription data to drug companies, the reports are used to promote safety and can be used to monitor cases in which large groups of patients are taking drugs that could have dangerous interactions.

Boston Globe May 25, 2003 page A1