Inexpensive Sponsored Meals For Doctors Increase Brand Name Prescriptions

MedicalResearch.com Interview with:
Colette DeJong
Medical student at UCSF and
Research Fellow at the UCSF Center for Healthcare Value.

MedicalResearch.com: What is the background for this study?

Response: Data released under the U.S. Sunshine Act reveals that in the last five months of 2013, over half of American physicians received free meals, gifts, or payments from the pharmaceutical industry. Recent studies have shown that doctors who receive large payments from drug companies—such as speaking fees and royalties—are more likely to prescribe expensive brand-name drugs, even when generics are available. Our findings, however, suggest that physicians’ prescribing decisions may be associated with much smaller industry payments than previously thought. We found that doctors who receive a single industry-sponsored meal—with an average value under $20—are up to twice as likely to prescribe the brand-name drug being promoted.

MedicalResearch.com: What are the main findings?

Response: Our study contributes evidence to a long-standing debate around industry-sponsored meals, which are the most common form of financial interaction between doctors and drug companies. Whether a formal dinner or a brief lunch in a doctor’s office, these encounters are an opportunity for drug company representatives to discuss brand-name drugs with physicians and their staff. Although these presentations may be educational, their content is not actively monitored by the FDA, leading some commentators to argue that the meals may unduly influence physicians’ prescribing decisions.

MedicalResearch.com: What should readers take away from your report?

Response: A recent study found that we spend an extra $73 billion per year on brand-name drugs when equivalent generics are available; $25 billion of this is paid by patients. Seniors receiving Medicare pay a median monthly copay of $1 for generics, but $40-80 for brand-name drugs. For seniors taking 10 or 20 monthly medications, the copays can become unaffordable and can make it really difficult for people to access the medications they need. Because of this, it’s a national priority to increase our use of generic drugs. With their lower out-of-pocket costs, generics have been linked to improved adherence and better outcomes for chronic conditions.

Our study suggests that sponsored meals for doctors are associated with increased use of brand-name drugs. Our data raises questions about current practices, but it’s also worth noting that there is not yet another standardized way to get drug information out to doctors. The FDA, Medicare, or insurers could set up alternative means of educating doctors about drug developments, but they haven’t done that yet.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: There’s a need for further research looking at the effect of sponsored meals on the cost and quality of prescribing. Studies could also examine other types of payments, like speaking fees or royalties.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

DeJong C, Aguilar T, Tseng C, Lin GA, Boscardin W, Dudley R. Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries. JAMA Intern Med. Published online June 20, 2016. doi:10.1001/jamainternmed.2016.2765.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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