Chicago Looks to License Pharma Reps

Chicago may license pharma reps as part of battle against opioid abuse

Chicago could become one of the few cities in the nation requiring pharmaceutical sales representatives to carry a special license, a measure that Mayor Rahm Emanuel says would help fight opioid addiction.

An ordinance the city expects to introduce next month would require pharmaceutical reps who promote medications to doctors and other health care professionals to track and provide to the city, if requested, the number of health care professionals they’ve contacted, information about drugs promoted, samples provided and whether doctors were compensated for their time. The city also is considering requiring pharmaceutical reps to track which doctors they contact, and potentially supply names to the city upon request.

As part of the licensing requirements, sales reps also would have to get additional training on prescription abuse, ethics and marketing practices from programs certified by the city. In addition, health care professionals and patients would for the first time be able to report any deceptive and unethical behavior by the sales reps to the city.

Currently, pharmaceutical reps must have only limited business licenses from the city, as must many other businesses.

The city is ironing out how it would enforce the ordinance and punish violators, though pulling a rep’s license might be one possibility, said Dr. Julie Morita, commissioner of the city’s Department of Public Health.

The licenses likely would cost about $750 a person annually, bringing in $1 million that would support the licensing program as well as help support treatment for addiction, Morita said. When asked if the ordinance was a way for the city to make money, Morita said in an email it was about protecting Chicagoans’ health and well-being.

Last year, 403 people accidentally died in Chicago from opioid overdoses, according to the data cited in a report by the Chicago-Cook County Task Force on Heroin, released this month. It’s part of a troubling national trend, Morita said.

“These medications were used because there was a strong belief they were safe and nonaddictive, which was not accurate, and that’s because (the pharmaceutical industry) misrepresented the dangers associated with these medications,” Morita said.

Pharmaceutical Research and Manufacturers of America, an industry group, declined to comment on the substance of Chicago’s proposal because it had not been able to review the details. But it did say in an emailed statement: “Industry interactions with health care professionals, however, are already extensively regulated by the U.S. Food and Drug Administration. Patchwork local and state initiatives are likely to disrupt the existing federal regulation of important scientific information that benefits both providers and patients.”

Washington, D.C., has had licensed reps for the past eight years, with a licensing fee of $175 per rep. Currently, 1,022 pharmaceutical reps are licensed. Enforcement is handled by the city’s Board of Pharmacy.

Jesse Witten, a partner at law firm Drinker Biddle & Reath in Washington, D.C., said he’s heard of some drug companies keeping their reps out of the city because of the law. “They don’t do enough business in D.C. to make it worth their while to get licensed,” said Witten, who represents pharmaceutical companies.

Chicago’s plan to regulate pharmaceutical reps is its latest effort to address opioid addiction.

Two years ago, the city of Chicago filed suit against five large drugmakers in Cook County Circuit Court, accusing them of marketing opioids such as OxyContin as “rarely addictive” and touting benefits that “lacked scientific support.” That suit is pending. The city also reached an agreement with pharmaceutical giant Pfizer earlier this year that commits the drugmaker to standards for marketing opioids.

The federal government has filed a number of lawsuits in recent years against pharmaceutical companies over such issues.

Illinois Attorney General Lisa Madigan said in a city news release that she supports the proposed ordinance as a way “to curb the abusive overprescribing of opioid painkillers that feeds our country’s heroin epidemic.”

The FDA prohibits marketing drugs for uses the agency has not approved. Also, federal law prohibits giving doctors anything of value in an effort to gain federal business, such as Medicare payments for drugs.

Lisa SchenckerContact Reporter Chicago Tribune