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It has long been known that payments by pharmaceutical companies to physicians affect the number of opioid prescriptions they write. But a study released Friday offers the first suggestion that they could also be linked to overdose tolls in their communities.
The aggressive marketing of prescription narcotics over the past 20 years has been largely blamed on the staggering toll of the opioid epidemic. But little research has supported this claim.
The new study, published in JAMA Network open nowshows that countries receiving such payments later experience higher overdose mortality rates, even when researchers have controlled many other possible influences.
The study did not prove a cause-and-effect relationship; the link between the two is an badociation.
The study also suggests that regular, trustful visits, such as regular lunches sponsored by drug sales representatives, are more important to promoting a company's prescription of drugs than large payments to physicians.
"What seems to matter the most is not the amount that doctors paid, but the number of times they were paid," said Magdalena Cerdá, badociate professor of health of the Population and Director of the Center for Research on Opioid Epidemiology and Related Policies. NYU School of Medicine.
Michael Barnett, Assistant Professor of Health Policy and Management at Harvard TH The Chan School of Public Health, who studied the role of physicians in the opioid epidemic, described the findings as "deeply troubling for the [opioid] crisis that we are all aware of. "
The annual number of prescriptions for painkillers such as oxycodone, hydrocodone and methadone has decreased in recent years as doctors, states, and public health authorities have reacted to it. epidemic of opioids.
According to the Centers for Disease Control and Prevention, overdoses of these drugs have killed nearly 18,000 people in 2017, even as illicit fentanyl has become the main factor behind the opioid crisis.
Prescription pain relievers – rather than heroin or fentanyl – are often the first opioids to which consumers are exposed.
Previous research had linked the commercialization of pharmaceutical companies to the prescription of opioids, but the researchers said their study was the first to extend the comparison to overdose deaths.
The new study compared federal data on overdose deaths in each county from August 1, 2014 to December 31, 2016. Physician payments for meals, conferences, consultations and travel occurred from August 1, 2013 to December 31, 2015.
The one-year time lag was intended to ensure that payments influence prescriptions rather than the more prescriptive physicians attracting larger amounts of money from pharmaceutical companies.
In March, researchers at Harvard and CNN published an badysis showing that doctors who prescribe more opioids are attracting more payments from pharmaceutical companies.
Barnett said that no matter how payments work, they have an influence. Known in the trade as "retailer", these efforts affect the decision-making of prescribers, he said.
"What this creates is an awareness (…) that will be closer to your mind – it's just easier to reach them," Barnett said.
The new study found that 434,754 payments totaled $ 39.7 million to 67,507 physicians, or about one in twelve physicians. The researchers found that one in five family doctors had received this type of marketing.
"The counties receiving such marketing have subsequently experienced high mortality," they wrote.
"In addition, opioid prescribing rates were strongly badociated with the burden of opioid marketing."
In most countries, this type of marketing is legal and unlimited.
Another research author, Scott Hadland, pediatrician and researcher at the Boston Medical Center's Grayken Center for Medical Addiction, said drug sales representatives play a legitimate role in educating doctors about medications.
But he said that doctors had other ways to learn about drugs, such as lectures and continuing education courses. To reduce overdose deaths, doctors, pharmaceutical companies and the government may have to regulate marketing, he said.
In 2017, New Jersey has put in place a regulation that limits the amount of money that prescribers can receive from pharmaceutical companies. And last year, Purdue Pharma, the maker of OxyContin, suspended its commercialization of opioids to doctors.
The Pharmaceutical and Manufacturers of America, the leading professional group of the pharmaceutical industry, said in a statement that prescribers involved in the care of patients with pain "should be informed of the basic principles of management of acute and chronic pain, as well as the range of available treatments "options and benefits and relevant risks".
2018 © The Washington Post
This article was originally published by The Washington Post.
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