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Docs Pen More Opioid Scripts When Pharma Reps Provide Perks



"Doctors who accept free meals and other small benefits from companies that manufacture opioids are more likely to prescribe these medicines,"

"There was a modest increase of about 9% in opioids that prescribed the drug One year after doctors received opioid marketing, if you think about it on a large scale, it has a big impact on the production of opioid prescriptions, "Scott Hadland, MD, MPH, of the Grayken Center for Addiction at the Boston Medical Center, Massachusetts tells Medscape Medical News .

The study was published online on May 14 in JAMA Internal Medicine.

prescribe pressure?

"Much attention has been paid to speech and large sums of money to a small number of physicians, but this study looked at the other side of the coin ̵

1; the small, subtle, low-value payments that are widely held across the country," said Hadland.

Using two linked databases – the Open Payments database and the Medicare Part D Opioid Prescriber Summary File – researchers assessed the extent to which prescription of opioid products by physicians to physicians in 2014 was associated with the prescription of opioids in 2015 ,

Among the 369,139 physicians who prescribed Medicare Part D opioids in 2015, 7% accepted 105,368 non-research payments for opioid products (excluding buprenorphine) in 2014, totaling approximately $ 9 million

pain management Specialists accepted the most money from pharmaceutical companies ($ 2.9 million), followed by physical medicine and rehabilitation specialties lists ($ 1.8 million) and anesthetists ($ 1.4 million)

Insys Therapeutics, Fentanyl Sublingual Spray ( Subsys ) made the most opioid payments in 2014 (about $ 4.5 million). Teva Pharmaceuticals USA and Janssen Pharmaceuticals paid physicians $ 869,155 and $ 854,251, respectively

Marketing included fees and / or fees (approximately $ 6.2 million to 3,115 physicians), meals ($ 1.8 million). Dollars to 97,020 physicians), travel ($ 730,824 to 1862 physicians). Tuition fees ($ 290,395 for 360 physicians) and education ($ 79,660 for 3011 physicians)

In 2015, physicians wrote 0.6 fewer opioid prescriptions than in 2014, but those who received opioid-related payments wrote 1.6 more opioid prescriptions [19659002] A median of $ 13 was reported for 25,471 physicians. In multivariate modeling, each additional meal paid by a drug company was associated with a 0.7% increase in opioid prescriptions.

A Little Money Goes A Long Way

"I really believe that the majority of doctors are trying to do that right for their patient." This marketing is subtle, and I think if you would ask most doctors "Does Marketing Affect Your Prescription?" Then my expectation is that the majority would say no, "said Hadland.

"What this study shows That the effect is small, but when applied to large populations of hundreds of thousands of doctors, that makes a big difference," said Hadland.

He noted that the legislation recently introduced in New Jersey would include the annual pharmaceutical company making marketing payments of $ 10,000 a year and doctor. But in this study, less than 2% of physicians received 1,000 or more total payments.

"It's just a very small minority of doctors who get a lot of money from drug companies, instead it's really so subtle, widespread practice of small, low-cost payments for things like meals that have the greater public health effect," said Hadland Medscape Medical News .

"That means we should not just look at the total dollar value doctors receive each year, but actually think about the number of pharmaceutical companies interactions that doctors have, because if you look at the data, each one was Meal A Doctor Received For Opioid Marketing Associated With Getting More Opioid Prescriptions A Type Of Almost Dose-Effect Type, "Hadland said.

Walid F. Gellad, MD, MPH, of the University of Pittsburgh Center for Pharmaceutical Policy and Prescribing in Pennsylvania, said the results of this study are not surprising. "It fits in with literature and common sense, but it's important to document, and the study seems well executed," he said Medscape Medical News .

It is striking how many doctors have received payments in certain disciplines.
Dr. Walid Gellad

"It's pretty striking how many doctors received payments in specific disciplines – over half of the pain doctors and almost a third of the physicians," Gellad said.

"You can discuss whether these payments are good or bad." He added, "But even more noteworthy is that half of all nonresearch payments are accused by a company [Insys] whose leaders and associates conspired for bribery and bribes in connection with inappropriate payments to education speakers were, "said Gellad.

American Pharmaceutical Research and Manufacturers did not respond to a request for comment on the study results.

The study had no commercial funding. Dr. Hadland and Dr. Gellad have no relevant conflicts of interest.

JAMA Intern Med. Published Online May 14, 2018. Full Text

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