[ad_1]
Many people cite prescription opioids as a point of access to the consumption of illicit opioids. However, while prescription opioids are implicated in over a third of opioid overdose deaths in the United States, the review of any correlation between overdose deaths of Prescription opioids and marketing of the pharmaceutical industry has been limited – until now.
New study from NYU School of Medicine and Boston Medical Center published online Jan. 18 JAMA Network open now shows that an increase in the marketing of opioids to physicians – a free consultation fee for meals – is badociated with higher opioid prescribing rates and a high number of overdose deaths in the United States. United
"Prescription opioids contribute to over 17,000 overdose deaths each year in the US Our findings suggest that it is urgent to examine the role that pharmaceutical marketing is playing in the world." the national opioid crisis, "said Magdalena Cerdá, DrPH, Associate Professor of Population Health and Director of the NYU School of Medicine's Center for Epidemiology and Opioid Policy and the lead author of the # 39; study. "The data suggests that when doctors target opioid marketing, they prescribe more opioids, which has an impact on opioid overdose deaths."
Cerdá and his co-researchers determined that $ 39.7 million in opioid marketing had been distributed to nearly 68,000 physicians in 2,208 US counties. Direct marketing to physicians includes a pharmaceutical company that covers meals, travel expenses, intervention fees, fees or physician consultation fees.
Counties that have received more marketing from the industry have seen an increase in the prescription of opioids – and have recorded a greater number of overdose deaths from opioids. The researchers also found that the number of marketing interactions with physicians was more badociated with overdose deaths than the amount spent. In fact, out of three additional payments to physicians per 100,000 population in one county, the number of opioid overdose deaths was 18% higher.
The study linked information from 2013 to 2016 in three national databases: the Open Payments database, which includes all payments made by pharmaceutical companies to physicians; Data on drug overdoses from Centers for Disease Control and Prevention (CDC) of 50 states and developing countries; and CDC data on opioid prescriptions dispensed in pharmacies. He also measured opioid marketing in three different ways: the total dollar value of marketing received by physicians; the number of payments made by the pharmaceutical industry; and the number of doctors receiving marketing.
The results suggest that the greater influence of pharmaceutical companies could be more subtle and widespread – such as low dollar value payments occurring on a very large scale. For example, the team's findings indicate that providing inexpensive but multiple meals for marketing purposes may impact more on a physician's prescribing model than high-value speech fees, leading to an increase in the number of overdose deaths in the future.
"We already know that one out of every 12 American doctors has been on the market for opioids, and this proportion was even higher for family physicians, of whom one in five was being marketed," Scott Hadland said. , MD, MPH, pediatrician and addiction researcher at Boston Medical. Grayken Center for Addiction Center and senior author of the study. "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 limits in the context of drug abuse. a robust and evidence-based response to the overdose crisis in the United States. "
In the United States, opioid prescribing rates have dropped since 2010, but they remain three times higher than in 1999, and counties in states experiencing high opioid-related overdose rates, such as Kentucky, Tennessee and West Virginia, also have the highest rates of opioid prescription.
How the study was conducted
The researchers badyzed the marketing information of the pharmaceutical industry from the Open Payments database (as required by the recent Physician Payments Sunshine Act) and linked this information to data related to the opioid prescription and overdose mortality at county level databases of the US Centers for Disease Control and Prevention. All counties in the United States with overdose data from August 2014 to December 2016 were linked to marketing data from August 2013 to December 2015 using a one-year lag to ensure that commercial interactions occurred before overdose deaths observed.
Overall, the average overdose mortality rate was 6.5 per 100,000 person-years in all counties. During the reference period, average marketing per county was valued at $ 732 per month and averaged 7.6 monthly payments distributed to an average of two physicians per month.
The research included other notable discoveries related to the geographic structuring of opioid marketing. For example, the Northeast had the highest concentration of opioid marketing and the lowest was the Midwest. The marketing dollars were mostly concentrated in counties with mixed ethnic and racial makeup and a lower percentage of individuals under 65 years of age. and greater unemployment.
Cerdá and his colleagues also identify the limits of their study. Although they examine the outcome of overdose deaths related to prescribed opioids, many of these deaths also include heroin, fentanyl or other very potent opioids, as well as others. substances such as alcohol, benzodiazepines or cocaine. In addition, the data sources used do not differentiate prescribed opioids from those acquired illegally. The Open Payments database that tracks marketing payments also ignores the nature of industry-physician interactions. some payments may have resulted in a better understanding of safe prescribing practices.
[ad_2]
Source link
