Pharma payments to physicians associated with higher prescribing of 2 drug classes
Researchers calculated that 1 additional payment, of a median value of $13, was associated with 94 additional days of oral anticoagulant prescriptions and 107 days of noninsulin diabetes drugs in the hospital referral region where it was made.
Regions where physicians received more payments from pharmaceutical manufacturers also had higher rates of prescriptions for oral anticoagulants and noninsulin diabetes drugs, a recent study found.
The cross-sectional analysis compared 2013 and 2014 data from the Open Payments system and Medicare Part D prescription fill records in 306 hospital referring regions in the U.S. The study included 45 million prescriptions for the 2 drug classes, written by 623,886 physicians to more than 10 million patients. Results were published by The BMJ on Aug. 18.
There were almost 1 million payments to physicians for oral anticoagulants totaling more than $61 million and about 1.8 million payments for noninsulin diabetes drugs of about $108 million. Researchers calculated that 1 additional payment, of a median value of $13, was associated with 94 additional days of oral anticoagulant prescriptions (95% CI, 76 to 112 days) and 107 days of the diabetes drugs (95% CI, 89 to 125 days) in the hospital referral region where it was made (P<0.001 for both comparisons).
Payments to specialists were associated with greater prescribing than payments to nonspecialists (212 vs. 100 additional days per payment related to anticoagulants and 331 vs. 114 days for diabetes drugs; P<0.001). For the noninsulin diabetes drugs, payments for speaking and consulting fees were associated with greater prescribing than payments for food and beverages or educational materials (484 days vs. 110 days; P<0.001).
The study does not prove causation between payments to physicians and increased prescribing, and it's possible that manufacturers market more in areas where prescribing is already higher, the authors cautioned. “Our findings do not necessarily suggest that payments by pharmaceutical manufacturers are harmful for patient care,” they wrote, but they then noted potential negative effects, including inappropriate or excessively costly prescribing. “Physicians and policymakers should consider these findings and their implications when establishing personal, institutional, or legislative policy related to payments by manufacturers of pharmaceuticals to physicians,” the authors concluded.