Physicians Who Receive Pharmaceutical Company Payments More Likely To Prescribe Opioids Interview with:

Vishal Bala Senior Quantitative Data Analyst CareDash

Vishal Bala

Vishal Bala
Senior Quantitative Data Analyst
CareDash What is the background for this study? What are the main findings?

Response: Prior research into physicians and their relationships with the pharmaceutical industry has typically retained a narrow scope, focusing on how payments may be associated with prescription habits (sometimes limited to specific regions) for specific categories of drugs. For example, Modi et al. 2017 and Bandari et al. 2017 explored these connections in the context of some urologic drugs specifically.

Research conducted by ProPublica in 2016 studied the connection between industry payments and physician prescriptions across some of the largest medical specialties, but was only able to look at “brand-name” vs. “generic” categories and were limited by overlapping timeframes for payments and prescriptions.

CareDash took this analysis further by using Open Payments and Medicare Part D data to investigate the relationship between payments made by individual companies for specific drugs and the prescribing habits of the recipient physicians for those drugs.

CareDash’s main findings are that healthcare providers who received payments for a drug from a pharmaceutical company are 5 times more likely to be high prescribers for that drug than those physicians who did not receive a payment. Physicians are 5.3 times more likely to prescribe a drug than their peers after they have received a payment for that drug from the manufacturer. When physicians already prescribe a drug significantly more often than their peers, they are 5.6 times more likely to later receive payment for that drug from the drug’s manufacturer. Looking at the opioid drug class specifically, CareDash found that physicians receiving payment on behalf of an opioid were 14.5 times more likely to prescribe that opioid over alternatives. What should readers take away from your report?

Response: These results highlight the importance of additional oversight and accountability for the pharmaceutical industry as a whole and the need for doctors to have access to non-industry sponsored educational materials. Our findings suggest that the financial relationship that many drug manufacturers cultivate with prescribers has the potential to influence the decisions doctors make for their patients. Additionally, our results underscore the danger of typical assumptions made about industry payments influencing physicians to prescribe against their patients’ best interests. We found that physicians can also receive payments from pharmaceutical companies on the basis of preceding prescriptions, which emphasizes that establishing causal links between pharmaceutical payments and physician prescriptions can be a complex endeavor. What recommendations do you have for future research as a result of this study?

Response: The CareDash analysis explored the connection between pharmaceutical payments and physician prescriptions when the payments were known to precede the prescriptions and when the prescriptions were known to precede the payments. This approach allowed us to shed new light on how the ordering of the events may affect the strength of their connection. Future research could expand on this work by isolating physicians who have not been associated with payments prior to prescribing a drug significantly more than their peers, and studying their likelihood to go on to receive their first payment on the basis of those prescriptions. Similarly, the physicians who have received payment without prescribing a drug significantly more than their peers could be studied to determine the likelihood of them going on to prescribe that drug at higher rates on the basis of the payments.

Future work, potentially with more data at hand, could also explore variations in our overall findings across different categories of payment, geographic regions, and with different dollar amounts given to physicians.


CareDash Study: Investigating the Connection Between Payments from Pharmaceutical Companies and the Prescribing Habits of Physicians

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Last Updated on March 23, 2018 by Marie Benz MD FAAD