Industry payments (even free lunches) influence docs’ prescribing

Researchers examining Medicare prescribing patterns of oral anticoagulants and non-insulin diabetes drugs have found that pharmaceutical marketing to physicians involving payments (from consulting fees to gifts and free lunches) was associated with physicians being more likely to prescribe those marketed drugs. Most physicians, however, don’t believe the drug company ties influence their prescribing, according to a study published August 18 the BMJ.

The authors studied 2013 and 2014 Open Payments and Medicare Part D prescribing data for commonly prescribed and marketed oral anticoagulants and non-insulin diabetes drugs. The data included 306 hospital referral regions, and nearly 46,000,000 Medicare Part D prescriptions written by 623,886 physicians to 10,513,173 patients.

They found that there was a total of $61,026,140 made to physicians (representing 977,407 payments).

According to the study’s abstract, industry payments to specialists were tied to higher prescribing of marketed drugs than were payments made to non-specialists. Similarly, payments for speaker or consulting fees, honorariums, travel costs and non-research grants were tied to higher prescribing of marketed drugs than payments for food and beverages, gifts or educational materials.

The study references previous research that suggests most physicians don't believe they're being influenced by drug company payments.

“Our findings of an association between payments and prescribing shows there are ties between the payments--even a $13 lunch--and prescribing. This suggests, but does not prove, that the payments are influencing prescribing. There are other possible reasons for the payments being tied to prescribing, such as the pharmaceutical companies marketing specifically to doctors that are already prescribing the drug (i.e. egg then the chicken...),” study author William Fleischman, MD, MHS, clinical assistant professor of emergency medicine, University of Maryland School of Medicine.

While this study didn’t look at dermatologists, specifically, and the drugs studied are not commonly prescribed by dermatologists, another recent study did include dermatologists’ prescribing patterns as they relate to industry payments.

It, too, looked at Medicare prescribing, but across 12 specialties, including dermatology, and found that, for each of the specialties studied, receipt of payments was associated with greater prescribing costs per patient, as well as a greater proportion of branded medication prescribing.

Disclosure: Dr. Fleischman is a volunteer researcher for CMS, the agency that administers the Open Payments program.