A study published this month in BMJ offers additional evidence of a correlation between payments by drug manufacturers to doctors and increased prescriptions for drugs developed by the latter.
The analysis of Medicare’s Open Payments program offers a statistical demonstration of a phenomenon supported by more than 20 years of suggestive data, though the study’s authors point out that most previous studies have relied upon self-reporting to obtain payment and prescribing data. Where a recent study published in JAMA established a link between the free meals pharmaceutical companies offer and increased prescriptions, this new study expands that purview to include payments for speaking and consulting fees, as well as indirect payments for education, or for food and entertainment.
Moreover, the authors see a potential connection between payments made to physicians and “substantial differences in regional prescribing.” They conclude that “one additional payment in a region [median value $13] was associated with approximately 80 additional days filled of the marketed drug in the region.” As damning as that sounds, the authors caution that their study doesn’t prove the payments actually led to the increased prescribing, and say that their findings should not be interpreted beyond a regional level.
Even absent clear evidence of causation, pharmaceutical companies continue to make payments to doctors, most of whom don’t believe they can be influenced, according to the study. Reporting by ProPublica undermines this claim, showing the industry’s efforts seem to specifically target physicians already under sanction for unnecessary prescribing. The preponderance of the evidence suggests pharmaceutical companies have a profit motive behind their actions, according to Charles Rosen, co-founder of the Association for Medical Ethics, who told ProPublica, “I think it’s crystal clear that their fiduciary duty is not to educate physicians and make public welfare better. It’s to sell a product".