Doctors who were treated to meals costing as little as $20 or less later prescribed certain brand-name pills more often than rival medicines, according to an analysis of United States federal data published on Monday.
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As part of the research, Dr. R. Adams Dudley of the University of California, San Francisco and colleagues analyzed prescribing information for four popular drugs from almost 280,000 Medicare physicians.
Most Medicare beneficiaries are in prescription drug plans where the median copay is $1 for generics and $40 to $80 for brand-name drugs, DeJong noted. And the more meals a doctor treated themselves to, and the more expensive they were, the more they prescribed the promoted drug. For Benicar, Bystolic, and Pristiq, the increased probabilities were 52, 70, and 118 percent, respectively.
The authors of the study says the research shows more education is needed for doctors on the development of drugs and in doing so could save on insurance costs.
The researchers that discovered that 36.8 percent of the MA physicians in the database received payments from the pharmaceutical industry, most commonly pharmaceutical company-sponsored meals at 71.1 percent. Low volume prescribing ( 10 per year) physicians were excluded from the analysis. The e-mails say that doctors are not being paid to prescribe their drugs. Pfizer said that it does not pay anything to health-care professionals.
The JAMA researchers noted that the Pharmaceutical Research and Manufacturers of America have voluntary guidelines, which allow meals and gifts to physicians of up to $100 in value. But the findings suggest these may not be sufficient to alter industry influence and prescribing patterns.
“Small payments and meals should continue to be monitored in the United States”.
And also in May, the JAMA Internal Medicine published a small study from the state of MA, similarly uncovering an association between payments from industry and modest increases in rates of prescribing brand-name statins (cholesterol-lowering medication). “There has been a backing away from the really extravagant and frankly embarrassing giveaways of huge gifts of value”.
The study found that the effect increased as doctors got more meals.
Pricier meals boosted brand scripts more than cheap ones, too, for all of the drugs except Pristiq. Another treatment, Lipitor, has been shown to work as well as Crestor, and a cheap generic was available for Lipitor.
The researchers included four classes of drugs statins, antidepressants and two that treat blood pressure.
“This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative”, Campbell wrote in an email.
“It’s not that it’s medically bad” for patients, Dudley said.
“You should ask your doctor, is there a generic that’s just as good whenever you start a new medicine”, Dudley said. Last year, government data showed that US doctors and teaching hospitals received $6.49 billion from drug and medical-device makers in 2014. About 95 percent of the majority of the payments were apparently in the form of sponsored meals that costs an average of less than $20 each. Furthermore, the relationship was dose dependent, with additional meals and costlier meals associated with greater increases in prescribing of the promoted drug.
For instance, the researchers found that doctors who never took advantage of a free meal centered around nebivolol, now the most popular beta-blocker on the market, only prescribed it 3.1 percent of the time they prescribed that class of drug.
Researchers looked at four target drugs prescribed to Medicare patients and found doctors who got a meal, during which drug companies presented information about their medications, were anywhere from 18 percent to 70 percent more likely to prescribe the drug, depending on the specific medication.
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In the study released Monday, a team led by Colette DeJong at the University of California, San Francisco examined four classes of medications, including those that treat high cholesterol, heart rhythm disorders, high blood pressure and depression. And the more meals they received, the greater share of those drugs they tended to prescribe relative to other medications in the same category.
