Association Between Industry Payments and Opioid Prescribing

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Investigators analyzed data from the Open Payments database and Medicare Part D Opioid Prescriber Summary File.
Investigators analyzed data from the Open Payments database and Medicare Part D Opioid Prescriber Summary File.

Non-research industry payments to physicians may be associated with increases in opioid prescribing rates, according to a study published in JAMA Internal Medicine.

Investigators analyzed data from 2 US databases, the Open Payments database, to determine all non-research payment from pharmaceutical companies to physicians during 2014, and the Medicare Part D Opioid Prescriber Summary File, to gather all claims from physicians who wrote opioid prescriptions filled for Medicare beneficiaries during 2015.

A total of 369,139 physicians who met study criteria prescribed opioids in 2015. The previous year, 25,767 of these physicians (7%) received 105,368 non-research opioid-related payments totaling $9,071,976. Marketing “payments” included speaking fees and/or honoraria, travel, meals, consulting fees, and education.

Physicians who did not receive opioid-related payments were found to have filed fewer opioid claims in 2015 than in 2014 (mean difference, –0.8), whereas physicians who received payments filed more opioid claims (mean difference, 1.6). Receipt of any vs no opioid-related industry payments in 2014 was associated with a 9.3% (95% CI, 8.7%-9.9%) increase in opioid claims in 2015.

Each payment for a meal in 2014 was associated with a 0.7% (95% CI, 0.6%-0.8%) increase in opioid claims in 2015.

The 3 companies with the highest payments to physicians were INSYS Therapeutics (which accounted for 50% of all non-research payments), Teva Pharmaceuticals USA, and Janssen Pharmaceuticals.

Physicians who receive payments from pharmaceutical companies may be more likely than others to prescribe opioids, noted the investigators. Thus, the association between payments and prescribing does not signify causality.

“[O]ur findings suggest that manufacturers should consider a voluntary decrease or complete cessation of marketing to physicians. Federal and state governments should also consider legal limits on the number and amount of payments,” concluded the study authors.

Reference

Hadland SE, Cerdá M, Li Y, Krieger MS, Marshall BDL. Association of pharmaceutical industry marketing of opioid products to physicians with subsequent opioid prescribing [published online May 14, 2018]. JAMA Intern Med. doi: 10.1001/jamainternmed.2018.1999

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