Doctors who receive pharma money prescribe more brand drugs

By Levin Simes
March 22, 2016

ProPublica studied five different specialties to compare the rates by which doctors who receive money from big pharma prescribe typically more expensive brand name medication, versus doctors who haven’t taken money from pharma.  The analysis found that doctors who receive $5,000 or more from pharmaceutical companies in a given year all prescribe more brand name medication.

Brand name prescriptions by pharma payments
Prescription rates of doctors receiving no pharma payments vs those receiving more than $5,000.

Psychiatrists increased brand prescriptions from 13.6% to 18.9%, an increase of 39%. Cardiovascular Disease specialists increased prescriptions of brand name drugs from 19.2% to 24.1%, an increase of 26%. Family Medicine specialists increased brand prescriptions from 18.7% to 25.8%, an increase of 38%. Internists’ brand prescriptions increased to 30.1% from 19.8%, an increase of 52%.  Ophthalmologist’s rate of brand prescription rose to 64.6% from 46.4%, an increase of 39%.

The analysis included doctors who made over 1,000 prescriptions in Medicare Part D, across 5 specialties. In all cases doctors who prescribed more brand name medication as a group were given more by pharmaceutical companies. Payments calculated included speaking fees, consulting, travel, meals and food, royalties, and gifts. The underlying data comes from the United States government’s Open Payments database.

An increase of 26% to 52% across five specialties in the rate of brand name prescriptions is not insignificant, and strongly suggests a causal relationship between pharmaceutical spending on doctors and higher prescribing rates of more expensive brand name drugs. Overall in California, 2 out of every 3 doctors accepted money or in kind payments from pharmaceutical companies in 2014. Across the nation that rate was as low as 24 percent (Vermont) or as high as 90 percent (Nevada).

Senator Charles Grassley (R-Iowa), who has previously pushed to make drug company payments to doctors publically available, said, “Since brand name drugs generally cost more than generic drugs, what doctors prescribe has major effects on Medicare and other payers in the health care system. I look forward to more data, more analysis, and to hearing from doctors about what influences their decisions to prescribe brand name drugs vs generic drugs.”

Listen to or read the the story, via NPR.

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