Doctors Paid by Drug Companies are More Likely to Prescribe More Brand Names

According to a ProPublica analysis, physicians who are paid by pharmaceutical companies prescribe drugs differently from colleagues who do not. Additionally, on average the likelihood of prescribing brand name medications increased with the more money received. Dr. Aaron Kesselheim, an associate professor of medicine at Harvard Medical School, said “It again confirms the prevailing wisdom … that there is a relationship between payments and brand-name prescribing,” Dr. Kesselheim provided guidance on the early versions of ProPublica’s analysis. “This feeds into the ongoing conversation about the propriety of these sorts of relationships. Hopefully we’re getting past the point where people will say, ‘Oh, there’s no evidence that these relationships change physicians’ prescribing practices.’”

The analysis compared payments from industry to doctors’ treatment decisions in Medicare’s prescription drug program. Receiving an industry payment was associated with a two to three-fold increased likelihood of prescribing brand name drugs at very high rates compared to other physicians in the specialty. The analysis showed that even small payments, such as meal, was linked to different prescribing habits.

The analysis does not prove that doctors prescribed a certain way because of industry payments. The correlational approach only indicates that payments are associated with a tendency to prescribe in a manner that is beneficial to drug makers.

Brand name drugs are more expensive than generics, which work just as well in most patients. For some medications, the generic version is not exactly the same as the brand name but is similar.
The ProPublica analysis showed that the proportion of doctors who receive industry payments varies between states. Compared to Vermont, Minnesota, Wisconsin and Maine, the rate in Nevada, Alabama, Kentucky and South Carolina was twice as high.

“You can debate if these payments are good or bad, or neither, but what isn’t debatable is that they permeate the profession.” said Dr. Walid Gellad, an associate professor of medicine at the University of Pittsburgh and co-director of its Center for Pharmaceutical Policy and Prescribing, who reviewed the analysis.

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