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Industry payments to doctors linked to increased prescriptions of brand-name statins
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Physicians in Massachusetts who received payments from industry were more likely to prescribe brand-name statins, according to findings published in JAMA Internal Medicine.
“As the United States seeks to reign in the costs of prescription drugs and make them less expensive for patients, our findings are concerning,” James S. Yeh, MD, and colleagues wrote.
Yeh, from the Program on Regulation, Therapeutics and Law (PORTAL), division of pharmacoepidemiology and pharmacoeconomics, department of medicine, Brigham and Women’s Hospital and Harvard Medical School, and colleagues linked Medicare Part D prescription claims data with a Massachusetts physician payment database to determine a relationship between industry payments to physicians and prescription of brand-name vs. generic statins.
The study population was 2,444 Massachusetts physicians who wrote prescriptions for statins that were paid for by Medicare under the Part D prescription drug benefit in 2011.
The outcome of interest was rate of prescribing brand-name statins.
Of the physicians analyzed, 36.8% received payments from industry. Of those, the most frequent type of payment was for company-sponsored meals (71.1%), Yeh and colleagues found.
Of the 1,559,003 prescription claims for statins in 2011 included in the study, 22.8% were for brand-name statins.
Physicians who had no payments from industry prescribed brand-name statins 17.8% of the time (95% CI, 17.2-18.4), according to the researchers.
Yeh and colleagues wrote that for every $1,000 in total payments from industry a physician received, the physician’s rate of prescribing brand-name statins increased by 0.1% (95% CI, 0.06-0.13; P < .001).
The researchers found that there was an association between payments for educational training and an increase in rate of prescriptions for brand-name statins (4.8%; P = .004), but no link related to other types of payments.
“For most patients described as having hypercholesterolemia, statins are interchangeable,” Yeh and colleagues wrote. “Given the large cost differences between generic and brand-name statins (two- to fourfold higher average wholesale price for brand-name statins), the financial effects on patients and the health care system are likely to be substantial. A recent study showed that initiation of generic statins was associated with improved [CV] outcomes among patients owing to better adherence.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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