More Opioids Prescribed By Doctors Who Received Free Pharmaceutical Lunches Interview with:
“Big Lunch Extras Reading” by Big Lunch Extras is licensed under CC BY 2.0Scott E. Hadland, MD, MPH, MS
Assistant Professor of Pediatrics | Boston University School of Medicine
Boston Medical Center
Director of Urban Health & Advocacy Track | Boston Combined Residency Program
Boston, MA 02118 What is the background for this study? What are the main findings?

Response: Numerous pharmaceutical companies have received media attention for their role in promoting opioid prescribing through speaker programs and other marketing plans in which large-value payments are given to a small number of doctors to promote opioids.

In our study, we sought to tell the other side of the story. We wanted to identify whether low-value marketing, including industry-sponsored meals, which are commonplace in the US, were associated with increased opioid prescribing.

We found that 1 in 14 doctors received opioid marketing from pharmaceutical companies in 2014, and those that received marketing prescribed 9% more opioids the following year. With each additional meal a doctor received, he or she prescribed more and more opioids the following year. Our sample included 43% of the active physician workforce in the US, suggesting how widespread and far-reaching this effect might be. What should readers take away from your report?

Response: Amidst a national opioid crisis, we should be very concerned about the practice of offering meals to promote opioids. This practice is normal and goes largely unquestioned throughout the US, and at the population level, probably contributes more to excessive prescribing nationally. Although recently proposed legislation in some states seeks to cap the dollar value of annual marketing received by doctors, our study demonstrates that a high cap (e.g., $10,000, a limit set by some legislation) would not regulate the large number of meals being provided to physicians to encourage prescribing. What recommendations do you have for future research as a result of this work?

Response: We recommend that studies examine whether policies that cap the number (not just dollar value) of meals and other marketing interactions physicians have with pharmaceutical companies are effective.

Disclosures: I have none.


Hadland SE, Cerdá M, Li Y, Krieger MS, Marshall BDL. Association of Pharmaceutical Industry Marketing of Opioid Products to Physicians With Subsequent Opioid Prescribing. JAMA Intern Med. Published online May 14, 2018. doi:10.1001/jamainternmed.2018.1999 

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Last Updated on May 14, 2018 by Marie Benz MD FAAD