Loading...
Concern about whether pharmaceutical nonresearch payments to physicians (i.e., speaking and consulting fees, free meals, and free travel) influence opioid prescribing prompted this study in which data on nonresearch payments to physicians in 2014 were linked with Medicare Part D claims data on opioid prescriptions written in 2015.
Researchers identified nearly 370,000 physicians who prescribed opioids in 2015. Of these, 7% received roughly US$9 million (≈$350 per physician) in nonresearch payments related to opioid products during 2014. Among physicians who received payments, nearly all received payments for meals. About 2% of physicians who received payments received $1000 or more. Total U.S. opioid prescriptions decreased slightly overall from 2014 to 2015 but increased among physicians who received payments; those who received payments wrote about 9% more opioid prescriptions than those who did not. The number of meals received correlated with the number of opioid prescriptions written. For example, physicians who received 2 meals in 2014 wrote a mean 200 prescriptions in 2015, whereas those who received >10 meals averaged about 800 prescriptions.
Hadland SE et al. Association of pharmaceutical industry marketing of opioid products to physicians with subsequent opioid prescribing. JAMA Intern Med 2018 May 14; [e-pub]. (https://doi.org/10.1001/jamainternmed.2018.1999)
Comment
Physicians who receive pharmaceutical nonresearch payments might have other reasons for prescribing more opioids. However, the significant association between opioid prescribing and payments for meals and travel expenses raises questions. If a causal relationship exists, the amount of money necessary to influence prescribing behavior ($350, on average) is quite small in relation to typical physician incomes.