There have been ongoing disputes about payments doctors receive from pharmaceutical companies and whether or not they impact how doctors opt to prescribe drugs to their patients. Evidence highlights the potential that doctors may base at least some of their prescribing of certain drugs on the payments they receive from pharmaceutical companies.

This practice is especially troubling in light of the high opioid prescription rates and overprescribing of opioids that have potentially played a role in the opioid epidemic in the United States.

An analysis conducted by ProPublica, and published by NPR, found that doctors receiving payments from the pharmaceutical industry prescribe differently than doctors who don’t. The more money a doctor receives, the more brand-name medications they are likely to prescribe.

The Analysis

ProPublica worked to match records relating to pharmaceutical and medical device companies in 2014 with data related to the medication choices of doctors in the Medicare prescription drug program. According to this analysis, when doctors received money from drug makers, they prescribed more brand-name drugs overall than doctors who didn’t. Even when a doctor received something as simple as a meal from a pharmaceutical company, they were more likely to prescribe brand-name drugs.

  • The higher the payments doctors received, the more their rate of prescribing brand-name drugs increased.
  • In 2014, doctors receiving more than $5,000 from companies had the highest rate of prescribing brand-name drugs.

ProPublica looked at doctors who wrote a minimum of 1,000 prescriptions in the Part D Medicare drug program.

It’s important to note that ProPublica’s analysis doesn’t show that a doctor is more likely to prescribe a certain drug or a certain company’s drugs. Instead, it indicates payments could be linked to a certain prescribing approach that’s likely to benefit large drug companies.

Physician Payments and Opioid Prescription Rates

Similarly, research published in the journal, Addiction, found there were links between payments and the prescribing rates of hydrocodone and oxycodone, which are two of the most prescribed opioids for Medicare patients.

While it’s illegal for pharmaceutical companies to pay doctors to prescribe certain drugs, drug companies can incentivize doctors in other ways, including consulting work, promotional speaking or covering meals and travel expenses. They can also send salespeople to physician offices to promote their drugs. This promotion can include taking doctors out for meals or leaving samples. Even though a doctor may not even realize they’re being incentivized to prescribe certain brands of drugs, they can start to subconsciously increase their prescribing of these drugs.

The data used in the research came from the Open Payments website, which publishes data under the Physician Payments Sunshine Act. This law requires U.S. medical manufacturers to disclose payments.

From 2014 to 2016, in an average year, doctors that received payments prescribed an additional 13,070 daily doses of opioids, compared to their colleagues who didn’t receive payments.

Dr. Thuy Nguyen, the head researcher on the study, said the results shed light on the role of promotional activities related to opioids and how often these drugs are prescribed. This study is observational, as is the analysis ProPublica, so it doesn’t necessarily show a causal link, but it does support some theories about physicians’ prescribing practices.  

Moving Forward

Looking at the role of payments and prescribing rates may help lawmakers identify ways to curb the opioid epidemic. Around 65% of people who use heroin say they used prescription opioids first. It’s estimated anywhere from 4–20% of opioid pills prescribed in the U.S. are taken for nonmedical uses, and the U.S. Centers for Disease Control is advising doctors to try not to prescribe opioids for many patients.

The recommendation is that doctors significantly cut back on the prescribing of at-home opioids for patients who have had surgery.

If you’re someone who’s living with opioid dependence or addiction, you aren’t alone. Reach out to The Recovery Village today to explore treatment programs and options available to help you.

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