Payments to doctors may increase prescription of opioids

US doctors who receive direct payments from opioid manufacturers tend to prescribe more opioids than doctors who do not receive such payments, according to a new study released by Addiction. The report found that the badociation between payments and prescription is strongest for hydrocodone and oxycodone, the most commonly prescribed opioids among Medicare patients (Americans over 65 years old and older). some younger people with disabilities). It is estimated that the Medicare population has the highest prevalence and highest growth of opioid consumption disorder in the United States. (1)

Pharmaceutical companies can not pay doctors to prescribe drugs; this kind of incentive is illegal. But they can pay doctors to talk about their medications at their conferences, and pay for consulting work and attending conferences. They can also send "retailers" (sellers) to doctors' offices to promote their medications, possibly paying for a meal or leaving drug samples. These types of incentives may encourage physicians, consciously or unconsciously, to prescribe a particular brand of medication or to prescribe it in greater quantities.

Data on direct payments to physicians comes from the Open Payments website, which publishes data reported in the Physician Payments Sunshine Act (PPSA), the US healthcare law that requires manufacturers of medical products to disclose payments and other value transfers to doctors. The data on opioid prescriptions comes from the Medicare Part D Prescribers' Public Use File, which contains data on prescriptions provided and completed by Medicare beneficiaries. Both sets of data are available on data.cms.gov, a website maintained by the Centers for Medicare and Medicaid Services (CMS).

The study, led by Dr. Thuy Nguyen of the School of Public and Environmental Affairs of Indiana University, examined the prescribing practices of 63,062 US physicians who were receiving direct treatment. opioid-related promotional payments, compared with over 802,000 physicians who did not receive any such payments. From 2014 to 2016, doctors who received payments prescribed, on average, more than 13,070 daily doses of opioids a year more than their unpaid colleagues.

Lead researcher Dr. Nguyen said, "Our research supports previous research on the pharmacist-physician relationship with opioid prescriptions and provides more complete evidence on the role of promotional activities. In simple terms, drug-related payments to physicians appear to increase the number of drug prescriptions and higher payments appear to increase them further. "

In an observational study, the results reveal badociations between opioid manufacturers' payments and the volume of opioid prescriptions by doctors, which might not be causal. However, the badociations remain after adjusting for a range of physician characteristics, local socio-demographic predictors, and opioid-controlled policies defined by the state.

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1. Lembke A, Chen JH. Using opioid agonist treatment for Medicare patients in 2013. JAMA Psychiatry. 2016 73 (9): 990-992.

Peer Review: Yes

Type of study: Longitudinal study

Subject of study: People

Funding: University

This document is available for free download from the Wiley Online Library (after lifting the embargo) or by contacting Jean O. Reilly, Editorial Manager, Addiction, [email protected], tel +44 (0) 20 7848 0452.

To speak with the senior author, Thuy D. Nguyen: contact her at the School of Public and Environmental Affairs of Indiana University, by email ([email protected]) or by phone (+1 314 817-6859).

Complete reference for the article: Nguyen TD, Bradford WD and Simon K (2019). Pharmaceutical payments to doctors can increase the number of opioid prescriptions. Addiction 111: doi: 10.1111 / add.14509.

Funding for this research was provided by the Major Challenges Initiative of Indiana University.

Addiction is a monthly international scientific journal that publishes research reports on alcohol, substances, tobacco, gambling, editorials and other debates. Owned by the Society for the Study of Drug Addiction, it has been in continuous publication since 1884. Addiction is number 1 in the 2017 ISI Journal Citation Reports magazine in the addiction category (scientific publishing).

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