Inexpensive Meals Entice Doctors to Push Costly Prescription Drugs
Several factors should contribute to a doctor’s prescribing habits – illness treatability, drug effectiveness and side effects, and potential addition to the drug.
However, there’s also one major factor that has nothing to do with ethical pharmacology. Namely, the kick backs from Big Pharma for doctors who prescribe expensive prescription drugs.
Past studies have found that there is indeed a link between the fringe benefits garnered by physicians from pharmaceutical salespeople, and the likelihood that the drugs they sell will be prescribed.
However, the latest research finds this can be achieved at a very low cost to Big Pharma.
About the Study
A recent UC San Francisco study revealed that even taking the doctor out for a relatively cheap meal (average price $20) increased the chance that the physician would prescribe the name brand prescription drugs promoted by the representative over less expensive generics.
Moreover, researchers examined the prescribing habits of nearly 280,000 Medicare Part D physicians from 2013. They discovered that those physicians who had been taken out for a meal increased the prescriptions of the drugs the rep was pushing.
From the study:
“…that physicians who received just one meal…were up to two times as likely to prescribe the promoted brand-name drugs as physicians who received no meals.”
Also, physicians who were dined more than once were 3 times as likely to prescribe the drugs in question.
The researchers examined the scripts of Medicare doctors in four common drug classes, including medications that (1) lower cholesterol levels, (2) treat hypertension, (3) address cardiovascular issues, and (4) antidepressants.
Furthermore, they determined the most often prescribed brand name drug in each of those areas: Crestor, Benicar, Bystolic and Pristiq.
Then physicians who were bought meals by pharmaceutical reps were identified.
‘…doctors who received four or more meals paid by the industry prescribed Crestor at 1.8 times the rate of those who received no free meals. The ratio was 4.5 times for Benicar and 3.4 times for Pristiq.”
Researchers caution that correlation does not imply causation, but note that there is a “strong association between the two events.”
The surprise here is that physicians are cheap dates, compared to what most of us thought. We imaged lavish gift, trips, and the like.
In fact, a ProPublica investigation earlier this year found that there was a proportional relationship between the amount of benefits a doctor receives from Big Pharma, and the chances they will write prescriptions on the promoted drugs.
Moreover, physicians who received over $5,000 from pharmaceutical companies in 2014 had the highest prescribing percentages of the name brand.
But the new study appears to show that these companies can spend far less and still see a significant return on their relatively modest investment.
What Does Big Pharma Say?
Of little surprise, PhRMA disagrees:
“This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative. Manufacturers routinely engage with physicians to share drug safety and efficacy information, new indications for approved medicines and potential side effects of medicines.”
Certainly, the problem is that Medicare recipients (i.e. older adults) often have numerous prescriptions, and they can be quite costly. They more name brand prescriptions that a doctor prescribes, the more expensive it gets for the patient.
~ G. Nathalee Serrels, M.A. Psychology