Doctors Paid By Drug Companies Tend To Prescribe Their Brand-Name Drugs More: Study

The findings of a new study appear to confirm suspicions that pharmaceutical companies are able to buy off doctors, and get them to prescribe their brand-name medications more often than generic drugs or their competitors.

Doctors who received industry payments were more likely to prescribe the drugs manufactured by the company that paid them, according to researchers with Harvard Medical School and Brigham and Women’s Hospital . The findings were published in this month’s issue of the medical journal JAMA Internal Medicine.

Researchers looked at Part D Medicare prescriptions claims data involving statins, a popular class of cholesterol drugs that includes the blockbuster drugs Lipitor and Crestor, as well as the Massachusetts physicians payment database.

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Out of the 2,444 Massachusetts doctors in the database in 2011, 899, or 36.8% received industry payments, in most cases just company sponsored meals. However, once those payments got larger, a discrepancy became apparent.

“For physicians with no industry payments listed, the median brand-name statin prescribing rate was 17.8%,” the researchers report. “For every $1,000 in total payments received, the brand-name statin prescribing rate increased by 0.1%.”

The study also found that payments linked to “educational training” boosted a company’s brand name drug sales by 4.8% with that doctor.

“As the United States seeks to rein in the costs of prescription drugs and make them less expensive for patients, our findings are concerning,” the researchers warned.

Such payments, often referred to as kickbacks, have long been a concern of the medical industry. Critics say that they lead to patients being directed toward more expense brand-name drugs as opposed to equally effective generics, and in some cases are directed to drugs they do not need or which may put them at unnecessary risk of side effects.

In recent years, a number of pharmaceutical companies have been hit with lawsuits from the Department of Justice over such promotional activities.

One of the largest resulted in a Pfizer settlement for $2.3 billion in 2009, after the drug maker was accused of illegal marketing and kickbacks associated with the painkiller Bextra and other drugs. Prosecutors said Pfizer gave doctors illegal incentives that included paying them for weekend meetings in resort locations.

In 2013, C.R. Bard agreed to pay $48.26 million to settle a whistleblower lawsuit which claimed it paid kickbacks to doctors who used its radioactive seeds to treat prostate cancer. The company gave them free medical supplies, grants, rebates, conferencing fees and marketing assistance.

Such kickback schemes are considered a form of Medicare fraud.

Just last year, Daiichi Sankyo agreed to pay $39 million to settle Justice Department charges that it illegally paid kickbacks to doctors who prescribed the hypertension drug Benicar and other medications.

According to the FBI and the U.S. Department of Justice, the kickbacks occurred between January 1, 2004 and March 31, 2011, in the form of honoraria payments, meals and other incentives that occurred as part of its Physician opinion & Discussion program and other programs.

Law enforcement officials say Daiichi Sankyo even paid doctors when they only spoke to their own staff in his or her own office, or even their own spouses. They also paid doctors for speaking engagements that never actually happened, according to the allegations.

Investigators say the company also paid the doctors through lavish meals which even sometimes exceeded the company’s own policy limiting such meals to $140 per person.

In 2009, payments from pharmaceutical companies to doctors was at about $188.86 million. By 2011, that number had jumped to $773.05 million, but much of that increase was attributed to companies being more willing to admit how much they had paid out.


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