Doctors who receive gifts from pharmaceutical companies tend to be more likely to prescribe more expensive drugs which are less effective, according to the findings of French researchers.
In a study published earlier this month in the medical journal The BMJ, researchers report that doctors who received gifts of more than $1,100 from drug companies were more likely to prescribe brand name drugs, instead of generic drugs, which cost their patients much more.
Researchers conducted a retrospective study using data from two French databases, the National Health Data System and Transparency in Healthcare database.
The Transparency in Health program records all conflict of interest for healthcare professional and gifts, including equipment, meals, and hotel costs offered by pharmaceutical companies and medical device manufacturers. Anything above 10 euros, or $11, must be reported.
The study included more than 41,000 general practitioners who worked exclusively in the private sector in France and had at least five registered patients in 2016.
Doctors were divided into six groups according to monetary value of the gifts they received from pharmaceutical, medical device, and other health related companies in the Transparency in Healthcare database.
Researchers also measured how much was reimbursed by the French National Health Insurance program for drug prescriptions per visit. Researchers used 11 drug prescription efficiency indicators from the National Health Insurance to calculate the performance related financial incentives of the doctors.
Reimbursements for prescriptions from the National Health Insurance program was much lower among doctors who reported no gifts, compared to doctors who reported at least one gift and doctors who reported more than €1,000 (about $1,100) in gifts.
Overall, doctors who reported no gifts in 2016 offered cheaper prescriptions to their patients and often gave prescriptions for generic medications instead of brand names.
The doctor group with no pharmaceutical gifts also prescribed generic versions of antibiotics, antihypertensives, and statins compared to small gift groups and the $1,100 gift group.
The group that didn’t receive gifts also prescribed fewer benzodiazepine prescriptions, like Xanax, Valium, and Klonipin, for more than 12 weeks. Doctors who received more than $1,100 in gifts often prescribed these drugs for much longer than 12 weeks, which can lead to dependence.
Recent reports in the U.S. indicate $46 million in pharmaceutical gifting from opioid manufacturers was intended to increase the sales of the addictive narcotic painkillers. Doctor prescribing has largely been to blame for the rising opioid abuse epidemic.
In the new study, the group of doctors that didn’t receive gifts also prescribed fewer prescriptions for vasodilators and angiotensin converting enzyme (ACE) inhibitors. They often prescribed the less expensive alternatives that are just as effective, including all ACE and tartan prescriptions.
There were no significant differences regarding prescribing practices for aspirin, generic antidepressants, and generic proton pump inhibitors between any of the doctor groups.
Nearly 90% of general practitioners in France received at least one gift since 2013, according to the new study. This is the first study of pharmaceutical gifts of this scale to be conducted in France.
In the U.S., pharmaceutical companies paid doctors more than $3 billion dollars in 2018 for prescribing their drugs and using their medical devices.
The new study reinforces the link that big pharma can influence the prescriptions of doctors and shows the extent of the influence, which can lead to less than ideal treatment and higher cost to the patient, the researchers concluded.