Lobbying Controversy at Bristol Myers

Lobbying Controversy at Bristol Myers

April 16th, 2012 // 1:09 pm @


Getting insurance coverage for a drug is always paramount. But what should a drugmaker do when a state Medicaid program or two refuse to play ball? One answer: enlist a few willing physicians to help your cause. Of course, there is a need to be discreet about how many doctors are asked by sales reps to write letters to the state programs. Why? Giving the appearance of an old-fashioned lobbying effort may not look too good.

That’s the message contained in an e-mail written earlier this week by a Bristol-Myers Squibb region business director to the district business manager team about the need to get Medicaid programs in Pennsylvania, Delaware and Maryland to place the Onglyza diabetes drug on the state formularies. As the e-mail indicates, legal counsel was sought and the Bristol-Myers team must tread carefully.

How so? The drugmaker does not want to “create the risk/appearance” of undertaking a concerted lobbying effort, even though this is a concerted lobbying effort. To create a veneer, the region business director instructed her compatriots to make sure the number of letters sent by doctors should be somewhat proportionate to the size of the state. And so, more docs should send letters to Pennsylvania Medicaid officials since this is a bigger state.

Pending further guidance from the Bristol-Myers legal department, the district business managers are also told that it would be safer not to confuse this letter-writing request with their regular detailing pitches. Why? “Delivery of the request should be separate from a call on Onglyza, so that we are not perceived as giving direction to the physician to include specific Onglyza messaging,” the region business director writes (click twice on the email to enlarge).

The region business manager goes on to say that the chosen doctors should be “Onglyza supporters with high Medicaid populations that will likely be concerned about patient access issues.” And she adds that the information will be shared with AstraZeneca, which is jointly marketing the diabetes pill, so there is no overlap. Coordination, she writes, “is key here.” After all, why have two drugmakers conduct the same surreptitious lobbying campaign? That might appear suspicious (here is the email).

Of course, lobbying state officials is nothing new, but it is always interesting to get a glimpse of the precise dance that is undertaken. Clearly, though, the Bristol-Myers team is concerned enough about its activity that the legal department needs to be consulted. And trying to disguise its effort is similar to the orchestrated campaigns in which funding was provided to grassroots patients groups for lobbying politicians.

The Bristol-Myers region business director did not respond to messages, but a spokeswoman for the drugmaker tells us this: “Bristol-Myers Squibb believes patients should have open access to medicines and works to ensure access to our medicines on government and private health plan formularies. The company works with various stakeholders with interest in open access including physicians who can provide their professional perspective as well as advocate or their patients.” There was no reply, however, in response to a question about why the drugmaker wants to pretend its lobbying is not lobbying.

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