Like a lot of other people, Bill Rock of Madison wonders why his prescription drugs are so expensive. He suspects it's due in large part to "huge mark-ups"; this, he reasons, would account for wide disparities in cost and the fact that providers like Wal-Mart can fill many common prescriptions for as little as $4.
To test his theory, Rock (not the local medical professional of the same name) tried to learn the actual cost of four common drugs. Knowing that the records of private pharmacies are, well, private, he made an information request of UW Health in November 2005. No response. He renewed his request this November, in a letter to UW Chancellor John Wiley, this time citing the state's open records law.
That drew a response from UW legal counsel John Dowling, who said this request "raised some very complicated questions that are impossible to answer simply." He said the university itself does not provide pharmacy service to the public and suggested that Rock address his request to UW Hospital and Clinics, a public authority.
Rock did, drawing a response dated Dec. 12, 2006, from Roger D. Miller, the hospital's associate legal counsel. Miller denied the request, saying the way it was phrased put it outside of the scope of the open records law.
"Moreover," Miller continued, "even if your request were resubmitted [to address this problem], UWHC would not release the pricing information for these drugs. The drugs that you were requesting information on were acquired by UWHC under a contract that requires confidentiality of pricing to be maintained." He said the hospital "could not access these drugs at the prices offered if it did not maintain confidentiality of this information."
What? The hospital is colluding with drug companies to keep secret how much it pays for prescription drugs?
"It doesn't surprise me," says Bobby Peterson, executive director of ABC for Health, a public interest group. But he is concerned: "The lack of transparency means we don't have a good idea how much institutions like the UW are marking drugs up." Indeed, he knows of no authoritative source that tells how much providers pay for the drugs they sell, meaning they can charge "whatever the market bears."
But in fact, the UW's zeal to conceal runs deeper than that. When Isthmus asked Miller for a sampling of contracts that contain secrecy clauses, he responded by giving "one recent example" from a pharmaceutical agreement:
"Confidentiality. Except as otherwise may be required to be disclosed by law, each party shall maintain the confidentiality of the existence of, and all terms and conditions of, this Agreement throughout the term hereof (and for a period of three (3) years thereafter."
Whoa! Not only can't UW Hospital and Clinics reveal how much it is paying for the drugs it buys - Miller also maintains this information is exempt from disclosure as a "trade secret" - it is contractually obligated to not reveal the existence of the contract it has entered into!
Now that's secrecy run amok.