Tracking, for Profit, Whether You Take Your Drugs–How Wrong Is This?

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FICO, the company that decides your credit score, is now predicting, for profit, whether you're likely to take your prescription drugs on schedule. No matter why FICO says they're doing it (insurance companies are their obvious clients) this is wrong in so many ways that it's hard to know where to start.

For one thing, information wants to be free: Your health insurance provider or doctor group won't be the only companies that see your "FICO prescription drug adherence score."  In some cases, your employer is effectively your insurer, and could hardly be denied access to your drug score. If you're tagged as at risk for not taking your insulin, you might be out of the running for a promotion.

Want to know if FICO is tracking you or what your score is? FICO won't tell you. Call your insurance company or doctor, they say. Want to know exactly why they think you're a risk? FICO won't tell you, and probably won't tell your doctor–it's a proprietary algebraic formula. Want to protest your score? Good luck. 

Insurance companies swear they only want to be able to remind high-risk patients to take their medicine, and that they won't use the information to hike your health insurance premiums. However, the score would be even more attractive in deciding whether to deny you treatment if you've been disobedient, even if you just couldn't afford your drugs.

FICO also apparently intends to sell your scores to pharmaceutical companies so they can sell us billions of dollars worth of more drugs. From FICO's press release:


The FICO Medication Adherence Score provides valuable insight to pharmaceutical marketing teams that until now has not been readily available,” said Eric Newmark, Research Manager at IDC Health Insights. “Considering that non-adherence to prescribed drugs is estimated to cost the pharmaceutical industry more than $35 billion in lost revenue annually, the FICO Medication Adherence Score can offer great value for marketing optimization and insight into ways to improve patient health. The solution is likely to drive synergies in other investments as well, such as remote patient monitoring and better ‘connected’ Medication Adherence.”

Once the information exists, promises about how it will or won't be used aren't binding.

Even the way the score is created is questionable. From the New York Times:


The score was created using data from a large pharmacy benefits manager that provided information for a random sample of nearly 600,000 anonymous patients with diabetes, heart disease and asthma. Using the data set, FICO was able to track the patterns of patients who filled and refilled prescriptions and those who didn’t. The company used the data to identify the variables most associated with medication adherence and developed a risk score on a scale of 0 to 500.

Now, to identify your personal risk of falling off the drug wagon, FICO  matches "publicly available" data like your neighborhood, your employment (or not) status, age, sex, marital status and home ownership with the data about the original sample of 600,000 (for which they knew who adhered to their prescription drug schedule and who didn't). Exactly what FICO looks at is secret, as is their formula for developing the score. FICO doesn't have to reveal whether it is accurate, or to what degree. And the score is really never better than an informed guess.

Drug companies have been seeking information on your "drug adherence" for years. They say it's only so they can send reminders. But they're already using it in a few places to try to sell you more and different drugs. They might also be sending you reminders to take a drug that your doctor has advised you to stop, because of side effects. Consumer Watchdog helped stop the drug companies from using this scheme in California and other states have also rejected it. But now Big Pharma has your FICO drug score, and so does the rest of the medical-industrial complex. 

Why would insurance companies pay FICO gobs of money for this information, since it's far less accurate for any individual than just checking whether they are refilling their prescriptions under their drug coverage? Ostensibly the FICO drug score would be cheaper than actually checking individual records, and would let insurers call and monitor the high risks (scores under 200) without bothering the rest of us.

But combining secrecy and profit with your personal information is a recipe for misuse. Especially when it has anything to do with your health.

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