Payments from drug companies to physicians are associated with greater regional prescribing of branded products, according to US research
One additional payment in an average hospital referral region — despite a median value of only US$13 — was associated with nearly three months of additional prescription days filled of the marketed drug over a 17-month period, researchers found.
“Less frequent, certain payments, such as those for specialists, as well as payments generally intended for physicians who provide ‘key opinion leadership’ through speaking to and educating the clinical community, have demonstrably larger effects on the prescribing of marketed drugs within hospital referral regions among all physicians,” they write.
The findings were based on an analysis of prescribing data for oral anticoagulants and non-insulin diabetes drugs from 306 hospital referral regions and payments made by drug companies to physicians.
It involved 46.2 million prescriptions written by more than 600,000 physicians for 10.5 million patients.
The study found that 977,407 drug company payments to physicians of US$61.0m (£46.2m) related to oral anticoagulants, and 1.8 million payments totalling US$108.4m related to non-insulin diabetes drugs.
One additional payment (median value US$13) was associated with 94 (95% confidence interval [CI] 76–112) additional days filled of marketed oral anticoagulants and 107 (CI 89–125) additional days filled of marketed non-insulin diabetes drugs (P<0.001).
Payments to specialists were associated with greater prescribing of marketed drugs than payments to non-specialists (212 versus 100 additional days filled per payment of marketed oral anticoagulants, 331 versus 114 for marketed non-insulin diabetes drugs, P<0.001).
Payments for speaker and consulting fees for non-insulin diabetes drugs were associated with greater prescribing of marketed drugs than payments for food and beverages or educational materials (484 versus 110, P<0.001).
 Fleischman W, Agrawal S, King M et al. Association between payments from manufacturers of pharmaceuticals to physicians and regional prescribing: cross sectional ecological study. The BMJ 2016;354:i4189. doi: 10.1136/bmj.i4189