For example, the Michigan RFP for tobacco quitline services in 2011 stated: "Applicants must be institutional members of the North American Quitline Consortium (NAQC)."
Similarly, the New Mexico RFP for quitline services in 2011 required: "Membership in North American Quitline Consortium."
And the Maryland RFP for quitline services in 2012 also required: "Membership in the North American Quitline Consortium."
With the help of its member state health departments, NAQC has thus been able to create an inside club of contractors who are in a sense subservient to NAQC by virtue of having to pay off NAQC simply for the right to be able to bid to provide state smoking cessation quitline services.
But the racket doesn't end there.
Apparently, states in need of quitline services are not allowed to post their RFPs to the NAQC list-serve, unless they too become NAQC members.
When Kentucky tried to use NAQC's members as a forum to announce its RFP for quitline services, NAQC refused:
"The Kentucky Tobacco Prevention and Cessation Program is trying to announce a quitline RFP to potential vendors, but is not allowed to send an email or ask the North American Quitline Consortium (NAQC) to post the RFP on their listserv."
NAQC responded: "Thank you for sharing this information with NAQC. As you guessed, Kentucky is not a member of NAQC and the NAQC listserv is only available to our members."
The Rest of the Story
I had no idea that the contractors providing state quitline services are all part of an insiders club that is beholden to the North American Quitline Consortium. The best potential contractor in the nation would not be eligible to even bid for a contract to provide quitline services in many states if it were not a member of NAQC.
This is really quite a racket they've got going.
What is so troubling, though, is why the state health departments are playing along. Why would state governments agree with the requirement that contractors must pay off NAQC in order to apply? Would not the state health departments want to identify the best and most qualified possible contractor, not merely chose their contractors from the subset of companies that have made their payments to NAQC?
Equally troubling is the fact that in order to "join the club," a service provider must necessarily create a conflict of interest for itself with Big Pharma. Since NAQC is funded by three pharmaceutical companies with a vested interest in having their products offered to quitline callers, contractors who join NAQC become members of an organization that is funded by, and advised by these pharmaceutical companies, which serve as corporate delegates to the group.
A quitline service provider that wished to remain independent of any possible pharmaceutical company influence and therefore chose not to join NAQC would not be eligible to provide quitline services in many states.
It seems that many states which are NAQC members require contractors to also be NAQC members. Is this a required part of their membership? Did they independently think of adding such a requirement to their RFPs or is this something that NAQC is requiring or encouraging?
This story illustrates exactly how pharmaceutical company influence can spread throughout the tobacco control movement. Here, NAQC is helping Big Pharma to maintain its influence on quitline services in many states by requiring the creation of a financial conflict of interest between those quitline providers and Big Pharma as a pre-condition of the providers even applying to contract with the state health departments.
The pharmaceutical companies could not have created such a beneficial racket for themselves if they thought of this arrangement themselves.
(Thanks to Pam Parker for the tip and for extensive background research used in this post.)