Prescription Privacy Is a Myth

In recent months, Los Angeles Times consumer columnist David Lazarus has disclosed the scummy practices of several national pharmacy chains, including misleading, if not outright lying, about charging customers for prescriptions they didn’t order, and telling them that their flu shots aren’t covered by their insurance plans when, in fact, they are.

In a column last month, Lazarus explains how consumer efforts to protect their medication privacy are routinely undermined by another despicable data-mining practice.

“Think you can keep a medical condition secret from life insurers by paying cash for prescription meds?” Lazarus asks. “Think again.

“A for-profit service called ScriptCheck exists to rat you out regardless of how diligent you are in trying to keep a sensitive matter under wraps.”

Data mining is the effort to scour databases of consumer practices and information in search of personal information that can be sold to companies for marketing purposes. It’s a sophisticated way of targeting a market, even if the people involved go to great lengths not to be identified or pitched products or services.

There are legitimate uses for divulging personal data, such as life insurers who need to know about the people whose lives they’re underwriting. It’s a matter of risk assessment in order to structure fair rates for everybody.

But, as Lazarus says, “[F]or anyone who is taking an antidepressant, say, or being treated for a chronic condition, privacy can be a key consideration. You may not want employers – or potential employers – to know what you’re taking. …”

So some people choose to pay for prescription medicine to avoid the paper trail that comes with credit-card purchases or those underwritten by insurers. But, according to Lazarus, it turns out that that strategy does not protect their privacy.

If someone purchases the information collected by ScriptCheck/ExamOne, a subsidiary of Quest Diagnostics, it can be notified of all prescriptions you’ve filled in recent years, regardless of how you paid.

Pharmacy benefit managers, who serve as the middleman between insurers and pharmacies, also keep detailed records of who takes what medicine. And Quest Diagnostics, one of the largest providers of medical diagnostic services, such as blood, urine and genetic tests, has voluminous records of the estimated 1 in 3 U.S. adults who interact with the company each year.

According to Lazarus, 48 states maintain databases that monitor people’s prescription-drug use, although access to the information is supposed to be limited to doctors, pharmacists and government officials.

He told the story of one psychiatrist whose patient wanted to keep his visits and his prescription meds confidential so they wouldn’t affect his career. Two months later, a life insurer contacted the shrink, asking for the patient’s entire medical file. The patient had applied for life insurance before starting treatment but he hadn’t subsequently disclosed that he was seeing a psychiatrist.

The patient, a health-care professional, he poked around only to discover that the insurer had contracted with ScriptCheck to find out what prescription drugs he was taking. “ScriptCheck,” the psychiatrist told Lazarus, “apparently takes the prescription information and the doctor’s name from pharmacy records and uses some kind of algorithm to guess someone’s diagnoses.”

“The level of intrusion – it’s shocking,” he said. “And it takes a lot to shock me at this point in my career.”

As Lazarus says, you have to understand that an insurer must be able to determine the risk of the people it underwrites. But you also have to understand that there are others who might not have such legitimate interests in your privacy, and that it’s wrong to let them indulge it.

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