Extensive research by ProPublica details how payments from medical device and pharmaceutical companies to doctors can influence their prescription behaviors.
“Doctors who receive money from drugmakers related to a specific drug prescribe that drug more heavily than doctors without such financial ties,” the analysis found.
In fact, the research showed that doctors who received payments were two to three times as likely to prescribe brand-name drugs as others in their specialty. And doctors who get payments related to a specific drug prescribe that drug 58 percent more heavily on average than doctors who don’t get payments.
Every patient should get the treatment and medicine they need in a safe and timely manner. But when cash payments are shown to cause doctors to prescribe more expensive and possibly unnecessary treatments, optimization reviews are needed.
Optimization reviews, or “prior authorizations” as they are sometimes called, are a tool used by Medicare, businesses and insurers to make sure patients are receiving the safest and most cost-effective care.
For example, optimization reviews can stop the over-prescribing of opioids, or flag that a patient is on a separate medication that has a dangerous interaction with another medication they are already taking.
They can also make sure make sure patients receive the most affordable, safest, and beneficial treatments, regardless of the doctor’s financial incentives.
According to a study by the National Institute of Health, industry payments to doctors lead to increased prescribing of the paying company’s drug, higher prescribing costs, and increased prescribing of branded drugs.
“If there are physicians out there that deny that there is a relationship [between payments and prescribing behavior], they are starting to look more and more like climate deniers in the face of the growing evidence,” Aaron Kesselheim, a professor of medicine at Harvard Medical School to ProPublica. “The association is consistent across the different types of payments. It’s also consistent across numerous drug specialties and drug types, across multiple different fields of medicine. And for small and large payments. It’s a remarkably durable effect. No specialty is immune from this phenomenon.”
The data bears this out.
Over the course of four years, the drug manufacturers of Linzess, which is used to treat irritable bowel syndrome, spent $29 million on payments to doctors. Doctors who received payments were 46 percent more likely to prescribe the drug than those who were not paid.
Doctors who took payments from the makers of Myrbetriq, which treats overactive bladder, were 64 percent more likely to prescribe the drug.
Doctors who took payments from the makers of Restasis, which treats chronic dry eye, were 141 percent more likely to prescribe the drug.
This is not to say that for some patients those prescriptions weren’t appropriate. It does, however, point to a financial relationship between payments from a drug maker and the prescribing of their drug.
And when such a relationship exist, optimization reviews are necessary to ensure patients receive the most appropriate and affordable care.
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