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Analysis

IBD Rx Tied to Pharma Payments to Docs

By MedPage Today  
   May 20, 2019

Among over 3,000 GI physicians, 99% received at least one payment.

The article was first published on Sunday, May 19, 2019 in MedPage Today.

By Randy Dotinga, Contributing Writer, MedPage Today

SAN DIEGO -- There was a significant link between the prescribing of biologic medications and the receipt of payments from marketing pharma companies, researchers reported here.

Every $1,000 in industry payments was associated with a $2,441 increase in prescription claims (95% CI $2,133-$2,748) for inflammatory bowel disease (IBD) drugs via Medicare (P<0.001, R2=6.49%), reported Rishad Khan, MD, of the University of Toronto, and colleagues.

The researchers accounted for patient volume, and the associated prescription cost was still significantly related to the value of industry payments, with every $1,000 in industry payments associated with a $3,846 increase in prescription claims (P<0.001, R2=7.64%, 95% CI $3,285 to $4,407), they reported at the annual Digestive Disease Week.

"I don't think it's necessarily nefarious," Khan stated. "But there's a clear association between physicians having financial relationships with industry, and those same physicians having higher prescription volumes and cost."

The researchers also found that among 3,475 gastroenterologists, 99% received at least one payment from a pharmaceutical company producing the biologic medications they prescribed, with a mean payment value of $130.

"Mainly it's meals, which get recorded as a payment," Khan said. "It might be worth $30 to $50."

The current findings line up with previous research linking physician marketing payments by pharma to higher prescription claims. A 2018 study tracked nearly 370,000 U.S. physicians, and found that the 7% who received millions of dollars worth of industry payments from opioid manufacturers in 2014 were 9% more likely to prescribe the drugs in 2015.

Khan and colleagues examined national databases for the years 2013-2015, and identified 3,441 gastroenterologists who prescribed the following IBD medications: adalimumab (Humira), certolizumab (Cimzia), golimumab (Simponi), infliximab (Remicade), and vedolizumab (Entyvio).

They looked at pharma payments to physicians for education; food, travel, and lodging; and consulting and speaking fees, honoraria, and gifts ("other").

A total of 3,024 gastroenterologists reported average food, travel, and lodging payments of $35.

Industry payments for education were $108 on average for 1,342 gastroenterologists. The spending on the "other" category averaged $2,303 among 748 gastroenterologists.

Khan highlighted study limitations. It's not clear how the increase in prescriptions affects the health of patients, he said, and "we don't know which came first -- the increased prescriptions or the spending." Also, "gastroenterologists who are already prescribing a lot of drugs may be targeted by their colleagues for their expertise," he added.

"The main take-away [from the study] is that there's an association between getting money from a pharmaceutical company and increased prescribing of their drug," he concluded.

Khan disclosed support from AbbVie and Ferring.

“I don't think it's necessarily nefarious. But there's a clear association between physicians having financial relationships with industry, and those same physicians having higher prescription volumes and cost.”


KEY TAKEAWAYS

Every $1,000 in industry payments was associated with a $2,441 increase in prescription claims for IBD drugs via Medicare.

A total of 3,024 gastroenterologists reported average food, travel, and lodging payments of $35.

The findings line up with previous research linking physician marketing payments by pharma to higher prescription claims.


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