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Comment & Response
October 2018

Reduced Opioid Marketing Could Limit Prescribing Information for Physicians—Reply

Author Affiliations
  • 1Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts
  • 2Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
  • 3Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento
  • 4Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
JAMA Intern Med. 2018;178(10):1426-1427. doi:10.1001/jamainternmed.2018.4366

In Reply In response to the letter from Ippolito and Veuger, our Research Letter1 provides support for an association between pharmaceutical industry marketing and opioid prescribing by physicians.2

First, to establish temporality between exposure and outcome, we lagged physician opioid prescribing from marketing by 1 year.1 This allowed us to ensure that prescribing changes occurred after marketing was received, thus reducing the likelihood of reverse causality. Analyses also adjusted for prior prescribing behaviors, which likely confound the relationship between marketing and subsequent opioid prescribing.

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