In an analysis of physicians who wrote at least 1,000 Medicare Part D prescriptions in 2014, ProPublica found that physicians who accepted compensation from drug companies and medical device manufacturers—even as little as a meal—were more likely to prescribe brand-name therapies rather than generics, as compared with physicians who did not accept such compensation.
The analysis focused on the prescribing habits of physicians in five specialties: psychiatry, cardiovascular disease, family medicine, internal medicine and ophthalmology. In addition to demonstrating that physicians who accepted payments from the medical industry were two to three times more likely to prescribe brand-name therapies at “exceptionally high rates” relative to their same-specialty peers who did not accept payments, the results indicated that higher levels of compensation were typically associated with increased rates of brand-name prescribing.
In general, physicians who received more than $5,000 in compensation from drug or device companies had the highest percentages of brand name prescribing. For instance, the average brand-name prescribing rate among internists who did not receive industry compensation was approximately 20 percent, whereas the rate among internists who received more than $5,000 in such compensation was approximately 30 percent.
ProPublica said the findings do not prove that industry payments influence physicians to prescribe specific drugs or a specific company’s drugs. What the findings do show is that this type of compensation is associated with “an approach to prescribing that … benefits drug companies’ bottom line.”
Although the analysis revealed wide variations among states in terms of the proportion of prescribers who accepted drug and device company payments, ProPublica said overall the practice is pervasive. For example, nearly nine out of 10 cardiologists included in the analysis received compensation from a drug or device company in 2014.
ProPublica acknowledged that in some cases few generic alternatives are available. In other cases, physicians might specialize in treating patients with complicated conditions that have not responded successfully to generic therapies.
The analysis included compensation for promotional speaking, consulting, business travel, meals, royalties, gifts and other types of payments, but not research payments.