Drug company payments to doctors, and opioid prescribing patterns

RECKLESS RX A new study from Boston Medical Center finds that marketing medicines to doctors can be as simple as taking a physician out for a $13 meal

RECKLESS RX A new study from Boston Medical Center finds that marketing medicines to doctors can be as simple as taking a physician out for a $13 meal

It's no secret that some physicians who receive thousands of dollars in consulting fees from pharma companies prescribe more opioids.

Hadland and his colleagues found that any type of opioid marketing in 2014 was associated with 9.3 percent more opioid claims in 2015, according to the paper out yesterday in the Journal of the American Medical Association. This includes industry-sponsored meals, speaking fees/honoraria, education, travel, consulting fees, and education.

In the study, researchers obtained information from two databases, first to identify nonresearch payments involving opioids other than buprenorphine products marketed for addiction treatment, and second to analyze claims from physicians who wrote opioid prescriptions filled by Medicare beneficiaries. INSYS Therapeutics, makers of fentanyl sublingual spray (Subsys) made payments totaling more than $4.5 million, followed by Teva Pharmaceuticals USA, which paid $869,155, and Janssen Pharmaceuticals, which paid $854,251. For each additional meal that physicians received, the number of opioids they prescribed increased.

Despite the national focus on massive payments to physicians, only 436 doctors - 1.7 percent of those receiving marketing - took payments greater than $1,000. Physicians who received such payments had 9.3% more opioid claims in 2015 compared with those who did not receive payments. "Our data suggest that the influence of marketing on physicians' prescribing is subtle yet widespread, and the pharmaceutical industry must look beyond their bottom lines and make changes to their marketing strategies in order to play a role in helping curb opioid overdose deaths".

"We may think of free meals as fairly innocuous, but in fact they do seem to have an impact", said Brandon Marshall, co-author and associate professor of epidemiology at Brown University School of Public Health. Study leaders say state and federal governments should put limits on the number and amount of payments to doctors.