Does Drug Industry Money Affect Cancer Prescriptions? Interview with:

Aaron Mitchell, MD Division of Hematology/Oncology, Department of Medicine,  Lineberger Comprehensive Cancer Center The Cecil G. Sheps Center for Health Services Research The University of North Carolina at Chapel Hil

Dr. Mitchell

Aaron Mitchell, MD
Division of Hematology/Oncology, Department of Medicine,
Lineberger Comprehensive Cancer Center
The Cecil G. Sheps Center for Health Services Research
The University of North Carolina at Chapel Hill What is the background for this study? What are the main findings?

Response: Financial relationships between physicians and the pharmaceutical industry are very common. However, we are just beginning to figure out whether these relationships may lead to potentially concerning changes in physician behavior – whether physicians tend to prescribe more of the drugs made by a company that has given them money. We decided to ask whether oncologists who receive money from drugmakers are more likely to use the cancer drugs made by companies that have given them money in the past.

In studying two specific groups of cancer drugs, one for kidney cancer and one for chronic myeloid leukemia (CML), we found that oncologists who had received payments such as meals, consulting fees, travel & lodging expenses from the manufacturer of one of these drugs tended to use that drug more. When looking at oncologists who received payments for research, we found increased prescribing among the kidney cancer drugs but not the CML drugs. What should readers take away from your report?

Response: Readers should understand that there is an association between receiving money from the drug industry and physician prescribing, even for cancer drugs, which we think of as being among the most expensive and potentially dangerous drugs – where the treatment decision should be ideally between the physician and patient without outside influences. Though our study cannot determine the causality of this relationship (whether physicians increase their prescribing after receiving payments, or whether drug companies start to give more money to physicians who already use more of their drugs), the relationship is potentially troubling and warrants further investigation. What recommendations do you have for future research as a result of this work?

Response: We have shown a relationship between pharmaceutical industry money and physician prescribing practices in oncology. But, what is the direction of this relationship? Do physicians start to use a company’s drug more after that company gives them money? Or, do drug companies “reward” high-prescribing physicians with more money in the future? Furthermore, what makes a physician more or less likely to use a company’s drug, after receiving money from them? Does the duration of the relationship between the drug company and the physician matter? Do conflict-of-interest restrictions prevent these relationships? Do the associations we found here apply to other areas of cancer treatment, besides just kidney cancer and CML? All of these are relevant questions raised by our current study.

We have no disclosures or conflicts of interest relevant to the findings in this study.


Mitchell AP, Winn AN, Dusetzina SB. Pharmaceutical Industry Payments and Oncologists’ Selection of Targeted Cancer Therapies in Medicare Beneficiaries. JAMA Intern Med. Published online April 09, 2018. doi:10.1001/jamainternmed.2018.0776

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Last Updated on April 9, 2018 by Marie Benz MD FAAD