Medical industry payments to doctors associated with higher rates of prescribing brand-name drugs

Association of Industry Payments to Physicians With the Prescribing of Brand-name Statins in Massachusetts

Another Study Finds Link Between Pharma Money and Brand-name Prescribing, propublica, May 9, 2016.

A group of researchers at Harvard Medical School has found that medical industry payments to physicians in Massachusetts are associated with higher rates of prescribing brand-name drugs that treat high cholesterol.

Abstract

Association of Industry Payments to Physicians With the Prescribing of Brand-name Statins in Massachusetts, JAMA Internal Medicine, doi:10.1001/jamainternmed.2016.1709, May 09, 2016.

Importance
Pharmaceutical industry payments to physicians may affect prescribing practices and increase costs if more expensive medications are prescribed.

Objective
Determine the association between industry payments to physicians and the prescribing of brand-name as compared with generic statins for lowering cholesterol.

Design, Setting, and Participants
Cross-sectional linkage of the Part D Medicare prescriptions claims data with the Massachusetts physicians payment database including all licensed Massachusetts physicians who wrote prescriptions for statins paid for under the Medicare drug benefit in 2011.

Main Outcomes and Measures
The exposure variable was a physician’s industry payments as listed in the Massachusetts database. The outcome was the physician’s rate of prescribing brand-name statins. We used linear regression to analyze the association between the intensity of physicians’ industry relationships (as measured by total payments) and their prescribing practices, as well as the effects of specific types of payments.

Results
Among the 2444 Massachusetts physicians in the Medicare prescribing database in 2011, 899 (36.8%) received industry payments. The most frequent payment was for company-sponsored meals (n = 639 [71.1%]). Statins accounted for 1 559 003 prescription claims; 356 807 (22.8%) were for brand-name drugs. For physicians with no industry payments listed, the median brand-name statin prescribing rate was 17.8% (95% CI, 17.2%-18.4%). For every $1000 in total payments received, the brand-name statin prescribing rate increased by 0.1% (95% CI, 0.06%-0.13%; P < .001). Payments for educational training were associated with a 4.8% increase in the rate of brand-name prescribing (P = .004); other forms of payments were not.

Image: David Sleight, ProPublica – Now There’s Proof: Docs Who Get Company Cash Tend to Prescribe More Brand-Name Meds, March 17, 2016.

Conclusions and Relevance
Industry payments to physicians are associated with higher rates of prescribing brand-name statins. As the United States seeks to reign in the costs of prescription drugs and make them less expensive for patients, our findings are concerning.

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