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Research Letter
July 8, 2019

Association Between Industry Payments to Physicians and Gabapentinoid Prescribing

Author Affiliations
  • 1Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington, Connecticut
  • 2Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
  • 3New England Mental Illness, Research, Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, Connecticut
  • 4Yale Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
  • 5Section of General Internal Medicine and the National Clinician Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 6Department of Health Policy and Management, Yale University School of Public Health, New Haven, Connecticut
JAMA Intern Med. Published online July 8, 2019. doi:10.1001/jamainternmed.2019.1082

Gabapentin and pregabalin are γ-aminobutyric acid analogues.1 Gabapentin (Neurontin; Pfizer) was approved by the US Food and Drug Administration (FDA) in 1993 for seizure disorders and postherpetic neuralgia; it became available as a generic in 2004. Two extended-release versions are marketed as brand-name products: Gralise (Assertio Therapeutics) and Horizant (Arbor Pharmaceuticals). Pregabalin (Lyrica; Pfizer) was approved in 2004 for seizure disorders, postherpetic neuralgia, neuropathic pain, and fibromyalgia; a generic formulation is not available. Patient use of gabapentinoids has increased from 1.2% of US adults in 2002 to 3.9% in 2015,2 raising concerns about appropriate use.3 We examined associations between industry payments to physicians associated with gabapentinoids and physicians’ prescribing.

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    1 Comment for this article
    Disclosure needed in Canada too
    Thomas Perry, M.D.,C.M. | University of British Columbia
    This study reminds us why transparency of Pharma payments to doctors, pharmacists, nurses, social workers, and other professionals would be extremely helpful.

    The Ontario government almost achieved this before a change of power. British Columbia has proposed an equivalent to Open Payments, but has yet to move. In Canada, academic medicine and medical associations seem to fear the loss of revenue. The Government of Canada does not appear seriously interested in cost controls or more rational prescribing.

    Help!

    Thomas L. Perry MD,CM, FRCPC
    University of British Columbia, Vancouver
    CONFLICT OF INTEREST: None Reported
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