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A new study says that aggressive direct marketing of doctors by pharmaceutical companies to doctors is linked to the continuing opioid abuse epidemic in the United States.
An badysis by county showed that opioid use was increasing in places where drug manufacturers focused their marketing efforts, said lead researcher Dr. Scott Hadland. He is a pediatrician and addiction researcher at the Grayken Center for Addiction at the Boston Medical Center.
"The counties that had the largest number of opioid products marketed by the pharmaceutical companies were those who, one year later, had more opioid prescriptions and more opioid overdose deaths," he said. Hadland.
The expenses of pharmaceutical companies did not have to be lavish to have an effect on the prescription of opioids.
The researchers found that pharmaceutical companies were gaining as much influence by buying a meal for a doctor while talking about their product as paying a lot of money to influential doctors in the form of consultation or consultation fees. .
OD opioid deaths increased by 18% with three additional marketing payments to physicians per 100,000 population in one county, researchers said.
Prosecutions and investigations targeting opioid manufacturers, such as Purdue Pharma, the maker of OxyContin, tend to overlook the impact of less flagrant marketing efforts, Hadland said.
On Wednesday, it was reported that court documents show that the family to which Purdue Pharma belongs has been trying to minimize the dangers of the opioid badgesic.
"The investigators focused on these valuable payments where a small number of doctors will receive tens of thousands of dollars to help promote an opioid product," said Hadland. But, "our data suggests that the most important public health problem is actually a much more subtle practice."
According to Hadland, "the dollar value of these payments is less important than the number of these marketing interactions that take place. The widespread practice of taking doctors for lunches or dinners to talk about opioids probably contributes more to the opioid crisis in the United States than these less frequent cases of physicians receiving very high value payments. "
At these lunches and dinners, drug vendors sold doctors on the idea that the pain was being outsourced. Sales representatives also downplayed the risk of opioid addiction and overdose, said Linda Richter, director of policy badysis and research at Center on Addiction in New York.
"Policy makers and state health regulators should ban licensed health professionals from accepting such payments or incentives from the industry," Richter said. "While doctors may think that the industry's marketing efforts have no impact on their prescribing choices, there is ample evidence to the contrary."
But a group representing drug manufacturers said that pharmaceutical companies have a role to play in relieving patients' pain while reducing the risk of addiction.
In fact, the US Food and Drug Administration "currently requires training to be provided to all health care providers involved in the management of patients with pain," said Priscilla VanderVeer, PhRMA Assistant Vice President of Public Affairs. . Pharmaceutical companies that manufacture opioid badgesics help fund this training, she said.
"Physicians and other prescribers need appropriate training and tools to meet the legitimate medical needs of their patients while reducing the risk of abuse. This training should be mandatory, "said VanderVeer.
Meanwhile, the crisis of opioid addiction in the United States continues. Drug abuse has resulted in nearly 50,000 overdose deaths in 2017, according to the US Center for Disease Control and Prevention.
Americans are now more likely to die from an opioid overdose than from a car or motorcycle accident, a fall, a drowning or an accident. choking due to food, concluded a report released Tuesday by the National Security Council.
Heroin and fentanyl are now much more often implicated in overdose deaths in the United States than prescription opioids, Hadland said.
"That said, prescription opioids are still involved in about one-third of overdose opioid deaths, and they are usually the first opioids that people encounter before they start having an addiction problem," he says. did he declare.
Under the Affordable Care Act, pharmaceutical companies are required to report their drug marketing expenses to US Medicare centers and Medicaid services.
These data showed that pharmaceutical companies spent $ 39.7 million in opioid marketing with 67,507 physicians in 2,208 counties in the United States between August 2013 and December 2015. A total of 434,754 payments have been performed, ranging from taking a meal to several thousand dollars in consulting fees.
Hadland and his colleagues compared these dollars and marketing payments with county-level data on opioid prescribing and deaths due to an opioid overdose kept by the CDC.
The researchers found that opioid prescription rates and overdose deaths increased with the money spent on marketing, the number of payments made and the number of doctors who received payments.
"What is clear from our badysis is that all of this marketing is related to a greater prescription of opioids and, as a result, to a high number of prescribed opioid deaths," said Hadland.
The investigators also found that the number of marketing interactions with physicians – the number of payments made – was more badociated with overdose deaths than the total amount spent. But the study found only one badociation and did not prove that the marketing efforts caused the overdose death.
"We already know that one in 12 American doctors has been on the market for opioids and that this proportion was even higher for family physicians, among whom one in five had received opioid marketing," he said. Hadland.
"Our findings suggest that marketing opioids directly to physicians could go against national efforts to reduce the number of overdose deaths and that decision makers should consider marketing limitations as part of a strong and evidence-based response to the overdose crisis in the United States, "he concluded. .
The results were published Jan. 18 in the journal JAMA Network Open.
(HealthDay News)
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