33 Comments

"They have built a Legal Paradigm that presumes records collected about us, do not belong to us" -E. Snowden

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How can we opt out of our individual data being used? What case could we make there and to what agencies?

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truthfully, you can NOT opt out. anything, or service that claims to help you accomplish, is a grift. data collection is insidious, and at every transaction. every one.

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Yeah this is my question. Shouldn't HIPAA bar this sort of nonsense?

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It is HIPAA compliant. IQVIA even develops products other companies use to stay HIPPA compliant.

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I don't recall being asked, but there's likely some million page long legal "agreement" I had to sign to receive medical treatment, which included handing my info over to these bozos. That sort of nonsense should be illegal under HIPAA but probably isn't.

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Yeah probably. Though it seems like the data in question here is all anonymized, if that makes you feel any better. But I doubt that.

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It did not sound anonymous to me. If they are targeting doctors and their patients, and which pharmacies are used, then they understand the data on an individual level, so I imagine it is used for other nefarious purposes too.

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founding
Dec 26, 2023Liked by Matt Stoller

you had me at "Lasso" and DeepIntent". Sounds like a Bond movie.

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they have grown so spoiled, after 40 years of a wink and a nod "regulation".. any resistance, at all.. produces 100 letters against Khan in the WSJ

simply spoiled children that buy the ideology of government bad.. so they can get away with the most blatantly illegal. and tell themselves, they are the victims, when someone has the balls to remind them of the standing laws.

fo so long, I trained my brain to resolve all this corruption as grand conspiracy, but occam's razor explains it simply. yes, there is a tremendous amount of conspiracy just the same, but the main driver.. is spoiled children.

it's high time for adults to enter the room

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Khan sounds like a hero.

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Dec 27, 2023·edited Dec 27, 2023

What kind of society allows marketing/pushing of drugs? We (and NZ) seem to be the only ones.

Drug ads cost billions and are paid with a hidden tax on each drug. The ads don't improve our healthcare system, rather, they are dangerous for our psychological well-being (they actually have diabetic patients dancing in a musical because they are taking the drug - sick?). Our medical data is not ours, just as your social media data isn't. Our corporatocracy's sole purpose is to monetize everything - profit above everything.

Please do a report on the pharma generic drug industry. There's no oversight - they can use any filler/buffer/additive they want - some are toxic, and really bad people run the firms. Bloomberg, WaPo, and the Pentagon are noticing and, like climate change and forever chemicals, it's much worse than you can imagine.

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I really dont watch tv anymore. except for a few niche shows.. like "how the universe works", the local weather, or food network.

and every single time we turn the tv on.. literally bombarded, saturated, with non stop medication ads... many of which in the very fast spoken small print include death as a side effect..

Im blown away. It truly is insane that the us allows drug ads. INSANE. they don't care. only money matters in an oligarchy. and the oligarchs? they need MORE, and quite literally are happy to kill us all to get it.

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Dec 27, 2023Liked by Matt Stoller

Hope the FTC prevails. Not sure how the trial will affect the CRO part of their business but the consolidation in the industry is scary. Also, glad to learn about the Sackler connection. If I have to change jobs - I know not to go to IQVIA😊

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Good piece, Matt. I appreciate you finding out whatever you could and bringing it to light. What is it going to take to have more default transparency in these trials?

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Also, how can you get more media to be reporting on this. Also the hypocrisy of HIPPA and the industry. My other health care is in Germany. I could mostly afford to pay for the medications I use here out of pocket there, but that does not mean all are available. Germany had a big shortage of some medicines, like cough medicine for children and people were going over the border to Holland to get prescriptions filled when their children had RSV. It seems that the USA has access to medicines that other countries do not. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428736/#:~:text=In%20this%20cohort%20study%20comparing,was%20extended%20by%204%20months.

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Dec 28, 2023Liked by Matt Stoller

A thousand times thank you. This is eye-opening.

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Dec 27, 2023Liked by Matt Stoller

Wow you nailed it. Was adjacent to this in the IMS days selling analytics to research. But "sales and marketing" was seen as a new lucrative niche. Exists only to get drs to push scripts: 50% of the time a patient asks for a drug, it's prescribed. Pharmas have the market covered - to consumers who ask and drs who comply.

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I know this isn't the focus of the current case, but isn't there an argument to be made that any business with 50-70% profit margins is a de facto monopoly? No business with real competition would ever have profit margins that high.

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author

Yes

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Great insight as always. Would love to see your breakdown on Vivek Ramswamy's Roivant and numerous "Vant' subsidiaries and the claimed pump and dump schemes where the model seems to be much more focused on raising money and selling off stakes than selling products. Curious to hear your thoughts. https://fortune.com/2023/06/14/vivek-ramaswamy-is-threatening-gop-heavyweights-in-the-polls-but-his-business-record-doesnt-live-up-to-the-hype/.

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author

Fortune did a good job

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We are also our own worst enemies. The vast majority of prescriptions are unnecessary but yet we not only fill the prescriptions and take them but renew them and the very worst ask for them or hope we are prescribed a drug as proof that we are indeed sick but now on the way to recovery. Think of antibiotics for clearly viral illness or blood pressure meds for marginally high blood pressures or cholesterol drugs for marginally high cholesterol levels with poor science on the effects of the very complex processes of blood flow. The number of people who need and take a drug for a valid and targeted purpose is mindbendingly small. But pharmaceuticals is huge.

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Really interesting case, Matt. I would think HIPAA laws preclude our preclude our personally identifiable information (PII) from being attached to those ad tech metrics. Maybe patients' names are anonymized, but the ad tech companies view granular demographics? Or maybe they found loopholes in HIPAA.

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I wonder how many more years the cornucopia of brazen "hot docs" will last. Clearly taking a while for monopolists to figure out they need better messaging discipline & early antitrust counsel to pull off anticompetitive capers in the Wu, Khan & Kanter era. An ounce of internal training is worth a pound of post hoc expert sophistry that's vulnerable to being undermined by candid docs from loose-lipped execs...

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author

I don’t think they’ll ever be able to stop accidentally saying the truth. It’s just too hard to stop.

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Could this be solved, BY isnt research being done on or at College`s level. in form of Grants by tax payers?

IF and when Multi Colleges doing their own research, studies, new things- findings and so-on. Can`nt Gov. then just pull say its 100 Schools. How hard will that be. to fine new things, or use of data research even. Then it would not be in one hand.

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Can you please explain the role that IQVIA plays in the advertising to doctors in other countries as well. At first this sounded like a US phenomenon, but if other countries are effected too, how does this work? Are there other countries that are trying to take this on as well? Or, is this more a USA problem?

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author

I don’t know how pharma marketing works outside of the U.S.

It’s almost certainly much more sane.

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I remember when we watched one of the movies about the Sachler family and oxycontin. Right when two of the characters were being pressured to get it into the German market, and they were unsuccessful, they said, the German market is hard because Germans accept pain, or something like that. My daughter and I looked at each other and said, "that is true." I cannot tell you what it is like to get my husband to take an aspirin. Which, in Germany has to be bought at a pharmacy, not a drug store like a Walgreens or CVS ,and it is expensive enough that I stock up here when I am going there, not that I need to. To make a long story short. Oxycontin did not get approval in Germany. From the film it seemed the Sackler company went after it, because if Germany accepted it, then other markets in the EU, and Europe would because they look to Germany as setting high standards for safety. So, there are probably fewer opioid addicts due to pain management than in the USA. Another things I know is that when my daughter's asthma medication in the USA, which cost $300 about 10 years ago, had to be picked up by a friend and mailed to us, because it was due to be replaced the day after we were going to Germany and the insurance company would not release it one day earlier. It was hard to get it through customs, so I had the pharmacist figure out what the equivalent was to that medication in Germany, and her doctor was then going to fax a prescription which I would have to pay out of pocket. In Germany it was going to cost me 30€, so almost 1/10 of the cost in the USA. Also, hearing aids are covered in Germany in insurance. So, I suspect that things are saner in Germany in terms of cost, but then I read that some medications are available in USA that are not in Germany, for example, the controversial Alzheimers med is not approved there, and so it is hard to say whether one can get all of the same meds in both countries. These articles discuss pricing controls in some European countries.

https://www.medicinesforeurope.com/wp-content/uploads/2022/06/New-pricing-models-for-generic-medicines.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193451/

https://www.commonwealthfund.org/publications/issue-briefs/2019/nov/what-can-united-states-learn-drug-spending-controls-france

What I don't understand is how the regulating is balanced between generics and non-generics. While Biden is trying to regulate what I presume are generics, is there a move to regulate non-generics as well?

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