A new study published in the Journal of the American Medical Association found that doctors receiving gifts from pharmaceutical companies were more likely to prescribe opioids.
The study undertook a thorough examination of the effects of the pharmaceutical industry’s marketing to physicians with regards to the rates at which opioids were prescribed in recent years. While the pharmaceutical industry’s practice of marketing to physicians is widespread and well known, no prior study had thoroughly examined the link between outreach from opioid manufacturers and the rates at which doctors prescribed opioids.
The study drew on several US databases and came to the conclusion that doctors receiving perks from pharmaceutical companies would prescribe more opioids. The researchers included data from some 370,000 physicians who prescribed opioids, and found that 7% of them received some kind of payment from pharmaceutical companies that was not research-related. In these cases, the sums were overwhelmingly below $1,000. But even with this relatively low amount, the study demonstrated that small perks went a long way: even something as simple as a single free lunch from a pharmaceutical representative correlated with the physicians writing substantially more opioid prescriptions in the following year.
The study additionally discovered that the doctors writing the most opioid prescriptions were also the ones receiving the most money from pharmaceutical companies. The data used in the study showed drug manufacturers invested substantial amounts of money into physician outreach, though three specific pharmaceutical companies stood out by leaps and bounds. Insys Therapeutics spent the most of any pharmaceutical manufacturer on physician outreach, giving physicians over $4.5 million worth of various perks, ranging from dinners to cash, paid out as “speaker fees.” Two other drug companies also topped the list with disproportionately large disbursements to physicians: Teva Phamaceuticals and Janssen Pharmaceuticals. Insys is currently a defendant in a case being handled by Phillips & Cohen LLP that alleged kickbacks to induce the sales of opioids.
The researchers caution that the correlations discovered in the study do not prove that payments from drug manufacturers directly affect prescribing habits. It is, for example, possible that pharmaceutical companies are seeking out doctors with particular expertise regarding opioids, and are therefore already prescribing at higher rates. While the researchers’ note softens the potentially alarming correlation discovered in the study, the study does raise questions regarding the role of the pharmaceutical industry in influencing the availability of opioids while the nation is gripped by an epidemic of addiction.
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