Opioid-related gifts received by clinicians impact their opioid prescribing patterns
The results of a novel study demonstrate that physicians who received opioid-related gifts from pharmaceutical companies were more likely to prescribe opioids to their patients, compared with clinicians who did not receive such gifts.
Researchers from the University of Pittsburgh Graduate School of Public Health (PA, USA) have conducted a novel database analysis and determined that physicians were more likely to prescribe opioids to their patients if they had received opioid-related gifts from pharmaceutical companies. The strength of this association was influenced by the dollar value of these gifts.
Lead study author Mara Hollander, a doctoral student in the University of Pittsburgh Public Health's Department of Health Policy and Management, explained: “For every 100 Americans, there were 58 opioid prescriptions written in 2017 – that is a tremendous amount of prescribing in a country that is struggling with an opioid epidemic.”
According to US federal law, pharmaceutical companies are required to detail the dollar values of any 'gifts' provided to physicians – including meals, travel and consulting fees – for products promoted by the company in association with the gifts.
In this study, researchers employed data from the Centers for Medicaid and Medicare Services (CMS; MD, USA) database concerning pharmaceutical companies' gifts to physicians during 2014–2015. These data were matched with Medicare information on the opioid prescribing patterns of 236,103 physicians during 2015–2016.
Researchers categorized participating physicians according to their specialties; seven groups of physicians were specified including primary care, surgery and pain medicine.
The results of the study demonstrate that, across all physician specialties, physician’s opioid prescribing was influenced by their receipt of opioid product-related gifts from pharmaceutical companies. However, the extent of this association was highly variable.
For example, primary care physicians were more than three times as likely to fall in the top 25% of opioid-prescribing physicians if they received opioid-related gifts valued at US$100 or more.
By contrast, psychiatrists and neurologists who received opioid-related gifts valued at at least US$100 were 13 times more likely to lie in the highest quartile of opioid-prescribing physicians, compared with psychiatrists and neurologists who received gifts of lower monetary value.
Senior study author Marian Jarlenski, an Assistant Professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, commented: “I would encourage policymakers and state and federal health officials to really dig into these findings and develop interventions that address this relationship between pharmaceutical company gift-giving and opioid prescribing. The opioid epidemic is nowhere close to being over.”
Hollander concluded: “Our research points to a potential motivator behind this prescribing that could be reduced through policy interventions.”
Hollander MAG, Donohue JM, Stein BD, Krans EE, Jarlenski MP. Association between opioid prescribing in Medicare and pharmaceutical company gifts by physician specialty.J Gen Intern Med. doi:10.1007/s11606-019-05470-0. (2019) (Epub ahead of print);