April's PharmedOut Fodder
ProPublica Proves Why Lunch,
and Other Gifts, Matter
For years, ProPublica has provided a public service by culling data into meaningful tools for healthcare consumers. Dollars for Docs is an easy-to-use database that allows you to find out how much money the pharmaceutical and device industries spent on, or gave to, your physician last year, and the Surgeon Scorecard assesses surgeons based on death and complication rates they have experienced for eight elective, common surgical procedures.
ProPublica has also been a standard-bearer in using this data to investigate important and fascinating stories. In March, they used 2014 physician payment records from pharmaceutical and medical device companies and matched them with Medicare prescription data for doctors.
The result is an eye-opening finding about how industry payments affect prescribing for Medicare beneficiaries and, quite possibly, other patients: "Doctors who got money from drug and device makers—even just a meal—prescribed a higher percentage of brand-name drugs overall than doctors who didn’t ... Indeed, doctors who received industry payments were two to three times as likely to prescribe brand-name drugs at exceptionally high rates as others in their specialty."
This comes as no surprise to PharmedOut, since our mission is to raise awareness about how industry marketing, particularly that which targets physicians, influences their prescribing decisions. And, how even gifts as small as lunch can make physicians feel subconsciously beholden to industry. It's a psychological phenomenon that we've written about and presented on, but that there has been relatively little research in this area.
That is what makes ProPublica's study so monumental to this cause. Even though it is common knowledge in the medical community that generic medications work just as well as their brand-name counterparts, and save patients and other healthcare payers money, industry payments have effectively given physicians temporary amnesia on this front.
As ProPublica notes, their analysis does not go so far as to point to the influence of one company or category of drugs. What it does show is that the systemic use of industry payments is having its desired effect: to boost branded drug prescriptions among targeted physicians.
Harvard Medical School professor and advocate Aaron Kesselheim is quoted as saying, "it again confirms the prevailing wisdom … that there is a relationship between payments and brand-name prescribing. This feeds into the ongoing conversation about the propriety of these sorts of relationships. Hopefully we're getting past the point where people will say, 'Oh, there's no evidence that these relationships change physicians' prescribing practices.'"
Yes, we hope so, too. Thank you ProPublica!