Doctors who regularly accept money and perks from pharmaceutical companies – and I’m not talking about a fruit platter for the office – prescribe the companies’ brand name products two to three times as often as their peers who don’t. This is important to all of us because brand name products cost substantially more than generics, often are not proven to provide better results, and contribute substantially to health care expenses passed on to taxpayers.
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This is not an opinion anymore. This is fact.
Under the Affordable Care Act (ACA), physicians for the first time must report all promotional speaking, consulting, business travel, meals, royalties and gifts, among other payments, bestowed upon them by pharmaceutical companies. The purpose of the Open Payments program is to gauge the effect of massive spending by pharmaceutical companies on prescribers. The results aren’t pretty.
Paid Doctors “Two to Three Times as Likely” to Prescribe Brand-Name Meds
Investigative journalists with ProPublica cross-referenced 2014 ACA data with 2014 prescriber information captured by Medicare. The data looked at the five specialties that prescribe the most: psychiatry, cardiology, family medicine, internal medicine and ophthalmology. Published in March, 2016, the analysis – which was guided by Harvard researchers and reviewed by other outside experts – found that the more money a doctor accepted, the more he or she prescribed the companies’ heavily promoted, brand-name drugs.
“Indeed, doctors who received industry payments were two to three times as likely to prescribe brand-name drugs at exceptionally high rates as others in their specialty,” the article stated. The study didn’t include payments for research, such as running clinical trials that doctors received.
Harvard Study: Pharma Money Influences Massachusetts
On May 9, 2016, Harvard researchers published their own study that looked solely at the relationship between industry payments and how Massachusetts’s doctors prescribed anti-cholesterol drugs known as statins. The results were the same: the more money a doctor took, the more brand-name statins he or she prescribed; specifically, rates of prescribing increased by 0.1 percent for every $1,000 in industry money received.
“A 0.1 percent increase in brand-name prescribing might not seem like much, but the study notes that brand-name statins cost two to four times wholesale as much as generics and that cost is an important factor in patient health outcomes. Patients are less likely to keep taking drugs that are more expensive,” according to Republican’s reporting on the research.
Both ProPublica and the Harvard researchers were careful not to assign a causal relationship between payments and brand name prescribing because there’s a lot that the data alone can’t show. For example, doctors who treat HIV patients tend to use newer drugs hoping for better outcomes. Or a drug may be one preferred by the patient’s insurer.
However, the choice to prescribe brand names benefits drug companies’ bottom line substantially more than their generics – a fact that can’t be ignored.
Lawmakers Should Take Heed
The study looked at medicines prescribed for Medicare beneficiaries only, since that is the only data the public can access. But it’s more than likely that doctors prescribe the same way for privately insured patients.
Congress already forbids Medicare from making drug companies bid competitively for the nation’s business. What Big Pharma wants to charge, taxpayers have to pay. Maybe these new findings will offer a dose of reality to lawmakers. Maybe they will begin to reign in Big Pharma’s contribution to out-of-control health care costs that affect all of us.