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May 23, 2000, Tuesday, Late Edition - Final

SECTION: Section A; Page 23; Column 1; National Desk

LENGTH: 993 words

HEADLINE: Doctors in Antitrust Fight Boycott Merck Products

BYLINE: By ROBERT PEAR

DATELINE: WASHINGTON, May 22

BODY:
Hundreds of doctors across the country have been boycotting drug products made by Merck & Company, one of the world's largest drug manufacturers, in a bitter fight over the collective bargaining rights of doctors, pharmacists and other health care professionals.

Leaders of the Federation of Physicians and Dentists, a labor union, called the boycott several weeks ago -- to punish Merck, they said, for its position on legislation pending in Congress. Doctors said the boycott would not harm patients and could eventually lead to improvements in the quality of care. But critics said the boycott showed that some doctors had allowed political considerations to outweigh the best interests of patients.

John J. Seddon, executive director of the federation, said, "We broadcast a fax and sent letters to all our members, 8,500 members in 25 states, telling them that we believe Merck's position was inappropriate."

The doctors demanded that Merck drop its opposition to a bill that, by granting an antitrust waiver, would make it much easier for physicians, pharmacists and other health care professionals to band together and negotiate with health insurance plans and managed care companies. Merck has a stake in the legislation because it has a subsidiary that manages drug benefits for 52 million people.

The doctors got some results with their protest, but the boycott continues because they want Merck to make a public retraction, by running newspaper advertisements and sending letters to all members of Congress.

"If Merck refuses," the federation said on May 4 in a notice to doctors across the country, "remember this above all else: Reward your friends and punish your enemies."

Neither house of Congress has yet voted on the bill, although the House could do so this week or shortly after the Memorial Day recess.

In an interview today, Mr. Seddon said that "doctors can feel comfortable boycotting a product as long as they know substitutes are available."

Dr. Carlton A. Richie III, a family practitioner at Tempe Primary Care Associates, in Arizona, said: "In writing new prescriptions, we boycotted every single Merck product. If someone came in with a blood pressure problem and we had a choice of Merck, Pfizer and Novartis products, we chose Pfizer or Novartis."

For example, Dr. Richie said, in recent weeks he has avoided Merck's Cozaar and prescribed Novartis's Diovan for patients with hypertension.

Some Merck employees said the boycott had produced a noticeable effect on sales. Gregory E. Reaves, a spokesman for Merck, refused to discuss sales figures and said the company had not considered them in deciding its position on the legislation.

Members of Merck's sales force have tried to mollify the doctors, although health policy experts at the company say some doctors are allowing political considerations to take precedence over the interests of patients.

Mr. Seddon, the executive director of the Federation of Physicians and Dentists, said doctors from his group and from professional societies had joined the boycott.

"Thousands of doctors are just simply not prescribing Merck products," Mr. Seddon said in the interview.

A Merck official said "it's safe to say hundreds" of doctors have joined the boycott. "It scared our sales force to death," this official said. "I have received two dozen calls from the sales force."

Merck tried to address the doctors' concerns by distancing itself from a coalition that opposes the legislation. The coalition includes Aetna U.S. Healthcare, the Blue Cross and Blue Shield Association, the Cigna Corporation and the United States Chamber of Commerce. In an advertisement opposing the bill, the coalition said, "Doctor cartels are bad medicine for patients."

Teel Oliver, Merck's vice president for government relations, wrote a letter to the federation this month stating that the company, based in Whitehouse Station, N.J., had no position on the bill and had been "inadvertently listed" as a member of the coalition. Merck-Medco Managed Care, of Franklin Lakes, N.J., the Merck subsidiary that manages prescription drug benefits, was indeed a member of the coalition, Ms. Oliver said, but is not currently a member and is not lobbying on the bill.

The bill was introduced by Representative Tom Campbell, Republican of California, and is tentatively scheduled for a vote on the House floor this week. The measure has 220 co-sponsors, a majority of the House, but there is no guarantee they will all vote for it.

The bill would exempt health care professionals from major provisions of the antitrust laws when they negotiate with health maintenance organizations and insurers over fees and contract terms.

Mr. Campbell says the bill would "allow health care professionals to present a united front when negotiating with H.M.O.'s." As a result, he says, the quality of care would improve, because doctors would be better able to advocate on behalf of patients.

Passage of the bill is a top priority for the American Medical Association. But the Federal Trade Commission and the Justice Department adamantly oppose it. Robert Pitofsky, chairman of the commission, said the bill "would create a broad antitrust exemption for price-fixing and boycotts by physicians, dentists, pharmacists and other health care professionals."

Doctors who are employees -- of hospitals, for example -- can collectively negotiate with their employers to seek higher compensation under existing law. Critics say Mr. Campbell's bill would grant similar immunity from the antitrust laws to doctors who are supposed to be competing with one another.

If the bill became law, Mr. Pitofsky said, costs to consumers and employers "would go up substantially."

The Congressional Budget Office said the bill would increase costs to private health plans, resulting in higher premiums, deductibles and co-payments for patients and "reductions in coverage by employers."
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LOAD-DATE: May 23, 2000