Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries | Geriatrics | JAMA Internal Medicine | JAMA Network
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    2 Comments for this article
    free lunch
    grumpy | private practice
    i don't take time for reps lunches<br/>however i \"use\" them to educate me<br/>What do you have? What is it for? what are advantages? Cost? Ins coverage?<br/>Leave samples and i may try it<br/>Truly not an abuse as other industries have.<br/>Why pick on doctors?
    CONFLICT OF INTEREST: None Reported
    Perhaps Higher Prescribing Rates Produce Free Cheap Lunches
    Stanley Hoffman, M.D. | Private Practice
    Pharmaceutical Reps don't have an unlimited budget for lunches. Perhaps the causality runs the other way. I get very few lunches but they are from reps who promote drugs that I am already prescribing. Expensive drugs like Jublia that I absolutely refuse to prescribe result in being dropped from the reps route, not only don't they not bring lunches, they just avoid my office.<br/><br/>It's not physicians being bribed, it's reps offering a little something to their best prescribers. Occasionally, they bring by copies of the latest studies or new indications.
    CONFLICT OF INTEREST: None Reported
    Original Investigation
    August 2016

    Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries

    Author Affiliations
    • 1Center for Healthcare Value, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco School of Medicine
    • 2Department of Family Medicine and Community Health, University of Hawaii John A. Burns School of Medicine, Honolulu
    • 3Pacific Health Research and Education Institute, Honolulu, Hawaii
    • 4Department of Medicine, University of California, San Francisco School of Medicine
    • 5Department of Medicine and Department of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine
    JAMA Intern Med. 2016;176(8):1114-1122. doi:10.1001/jamainternmed.2016.2765
    Key Points

    Question  Is the receipt of pharmaceutical industry-sponsored meals by physicians associated with their prescribing the promoted brand-name drug at higher rates to Medicare beneficiaries?

    Findings  In this cross-sectional study of 279 669 physicians, physicians who received a single meal promoting the drug of interest, with a mean value of less than $20, had significantly higher rates of prescribing rosuvastatin as compared with other statins; nebivolol as compared with other β-blockers; olmesartan as compared with other angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers; and desvenlafaxine as compared with other selective serotonin and serotonin-norepinephrine reuptake inhibitors.

    Meaning  Receipt of industry-sponsored meals was associated with an increased rate of prescribing the promoted brand-name medication to Medicare patients.

    Abstract

    Importance  The association between industry payments to physicians and prescribing rates of the brand-name medications that are being promoted is controversial. In the United States, industry payment data and Medicare prescribing records recently became publicly available.

    Objective  To study the association between physicians’ receipt of industry-sponsored meals, which account for roughly 80% of the total number of industry payments, and rates of prescribing the promoted drug to Medicare beneficiaries.

    Design, Setting, and Participants  Cross-sectional analysis of industry payment data from the federal Open Payments Program for August 1 through December 31, 2013, and prescribing data for individual physicians from Medicare Part D, for all of 2013. Participants were physicians who wrote Medicare prescriptions in any of 4 drug classes: statins, cardioselective β-blockers, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers (ACE inhibitors and ARBs), and selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs and SNRIs). We identified physicians who received industry-sponsored meals promoting the most-prescribed brand-name drug in each class (rosuvastatin, nebivolol, olmesartan, and desvenlafaxine, respectively). Data analysis was performed from August 20, 2015, to December 15, 2015.

    Exposures  Receipt of an industry-sponsored meal promoting the drug of interest.

    Main Outcomes and Measures  Prescribing rates of promoted drugs compared with alternatives in the same class, after adjustment for physician prescribing volume, demographic characteristics, specialty, and practice setting.

    Results  A total of 279 669 physicians received 63 524 payments associated with the 4 target drugs. Ninety-five percent of payments were meals, with a mean value of less than $20. Rosuvastatin represented 8.8% (SD, 9.9%) of statin prescriptions; nebivolol represented 3.3% (7.4%) of cardioselective β-blocker prescriptions; olmesartan represented 1.6% (3.9%) of ACE inhibitor and ARB prescriptions; and desvenlafaxine represented 0.6% (2.6%) of SSRI and SNRI prescriptions. Physicians who received a single meal promoting the drug of interest had higher rates of prescribing rosuvastatin over other statins (odds ratio [OR], 1.18; 95% CI, 1.17-1.18), nebivolol over other β-blockers (OR, 1.70; 95% CI, 1.69-1.72), olmesartan over other ACE inhibitors and ARBs (OR, 1.52; 95% CI, 1.51-1.53), and desvenlafaxine over other SSRIs and SNRIs (OR, 2.18; 95% CI, 2.13-2.23). Receipt of additional meals and receipt of meals costing more than $20 were associated with higher relative prescribing rates.

    Conclusions and Relevance  Receipt of industry-sponsored meals was associated with an increased rate of prescribing the brand-name medication that was being promoted. The findings represent an association, not a cause-and-effect relationship.

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