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When drug company representatives visit your doctor's office, they're bringing more than coffee mugs and free lunch: They have a detailed log of exactly what your doctor prescribes, how often and when.

They use the information to create targeted marketing plans in an effort to sway doctors to prescribe their products.

Washington's state legislators are considering a bill to make it illegal to buy detailed prescription practices for marketing, and a dozen other states have considered similar measures. Laws have passed in Vermont, New Hampshire and Maine restricting or banning the practice, although in the latter two sates, the laws were challenged by pharmaceutical companies and overturned by federal judges.

Drug companies say such restrictions would be dangerous for patients and would violate their commercial free speech rights. They also note that physicians can opt out.

The marketing depends on a practice called "data mining," where drug companies buy detailed prescription data from pharmacies, then match it with prescriber numbers purchased from the American Medical Association.

By linking the two data sets, drug companies get a comprehensive catalog of prescription data.

Because prescriber numbers are assigned to every doctor, even those who aren't members of the AMA are included in the database. The AMA makes about $45 million by selling the list every year. That amounts to about 15 percent of the organization's budget.

"Essentially, there's not a doctor in the country whose data is not being purchased from the drug companies," said Dr. Rupin Thakkar, a pediatrician from Edmonds, Wash. Even though he refuses to meet with drug reps, he said the marketing technique has nonetheless reached him.

Thakkar said he felt his privacy was invaded when his colleagues approached him with information he thought was private. He's also worried about what it means for his patients.

The federal health privacy law known as HIPPA prohibits patient identifiers from being shared or sold without patients' permission. But Thakkar said it could be possible to identify individual patients in small communities.

Critics also say the practice increases costs, violates doctor-patient privacy and can jeopardize consumers' safety by pushing newer drugs that aren't necessarily more effective.

"What we know for certain is that this form of marketing absolutely influences doctors' prescribing practices. We also know that it increases costs. Pharmaceutical companies would not be spending $3 billion a year if they were not profiting from it," said Robby Stern, a lobbyist with the Healthy Washington Coalition, a broad-based group lobbying for more affordable health care.

"We're in a situation where the states are becoming the only line of consumer protection defense on this stuff," Stern said.

Drug companies and data mining companies counter that it's difficult — if not impossible — to differentiate between marketing and research. They also said such a law would violate their commercial free speech rights.

"When you look at the bigger picture, new therapies often prolong life, increase productivity and diminish costs," said Robert Hunkler, a spokesman for IMS Health, a company that compiles the data.

Hunkler said the AMA already has an opt-out program that allows physicians to decline to have their data shared with marketers.

Physicians who opt out must do so every three years. Their information is still sent to companies that buy it, but they essentially promise not to use it.