Doctors receiving pharma payments more likely to prescribe brand-name drugs

By Sabrina Bodon | PublicSource | March 18, 2016

It’s been a question, and a suspicion, for a long time: Do doctors who get payments from pharmaceutical companies change their prescribing habits?

A ProPublica analysis sought to answer that, and it reports that doctors who receive cash benefits from the industry are far more likely to prescribe brand-name prescriptions over generics to patients.

Doctors can be paid for a variety of services they perform for the companies, like speaking engagements and research.

Throughout the country, about 75 percent of doctors in the five most common medical specialties (family medicine, internal medicine, cardiology, psychiatry and ophthalmology) received at least one payment from a company in 2014.

From the report:

Nationwide, nearly nine in 10 cardiologists who wrote at least 1,000 prescriptions for Medicare patients received payments from a drug or device company in 2014, while seven in 10 internists and family practitioners did.

The highest percentage of doctors receiving at least one benefit was concentrated in Nevada at 90 percent. About 78 percent of Pennsylvania doctors received at least one payment.

As payments to doctors increased, so did the brand-name prescribing rate. The typical rate for doctors receiving upward of $5,000 was about 30 percent; doctors who aren’t receiving payments prescribe brand name meds about 20 percent of the time, according to the ProPublica report.

ProPublica conducted the analysis by cross-referencing 2014 records of payments from pharmaceutical and medical device makers to data on doctors’ medication choices.

“You can debate if these payments are good or bad, or neither, but what isn’t debatable is that they permeate the profession,” Walid Gellad, an associate professor of medicine at the University of Pittsburgh and co-director of its Center for Pharmaceutical Policy and Prescribing, said to ProPublica.

Studies upon studies have featured generic medication to be equally effective as brand-name medication. The difference usually only being that brand-name drugs are typically more expensive to the user and widely advertised, according to the article.

Dr. Kim Allan Williams Sr., president of the American College of Cardiology, told ProPublica the relationship stems from the idea that as a medical professional prescribes more of a drug, the likelihood of their interaction with a company grows.

The more physicians learn about a new drug’s “differentiating characteristics,” he said, the more likely they are to prescribe it. And the more they prescribe it, the more likely they are to be selected as speakers and consultants for the company.

“That dovetails with improving your practice, and yes, you are getting paid to do it,” he said.

ProPublica has introduced several tools to help patients review their doctors, including Dollars for Docs, which shows whether the doctor has received payments from drug companies, and Prescriber Checkup, which allows users to see the pattern at which a physician prescribes certain medications.

Reach PublicSource intern Sabrina Bodon at sbodon@publicsource.org.