HealthDay News – A new study in JAMA Internal Medicine showed that physicians who accepted a single pharmaceutical industry-sponsored meal valued at less than $20 were more likely to prescribe a more costly brand-name drug than its generic alternative, compared with clinicians who did not accept a meal.

University of California, San Francisco, researchers linked information from 2 federal databases. The team identified the most-prescribed brand-name drugs in each of 4 common drug classes in 2013. These included Forest Laboratories’ Bystolic (nebivolol) and Daiichi Sankyo’s Benicar (olmesartan medoxomil), as well as AstraZeneca’s Crestor (rosuvastatin calcium) and Pfizer’s Pristiq (desvenlafaxine succinate).

The researchers found 279 669 physicians received 63 524 payments totaling $1.4 million related to the 4 brand-name drugs. Ninety-five percent of payments were for meals, with an average cost of less than $20. Of those doctors, 155 849 wrote more than 20 prescriptions in at least 1 of the 4 categories. 


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Even after adjusting for other factors like prescribing volume, doctors who received a single meal were more likely to prescribe Crestor over other statins, Bystolic over other β-blockers, Benicar over other angiotensin-converting enzyme inhibitors, and Pristiq over other antidepressants.

Payments for food and beverages provided to doctors totaled $224.5 million in 2014, JAMA Internal Medicine editor-at-large Robert Steinbrook, MD, noted in an accompanying editorial.

“If drug and device manufacturers were to stop sending money to physicians for promotional speaking, meals, and other activities without clear medical justification and invest more in independent bona fide research on safety, effectiveness, and affordability, our patients and the health care system would be better off,” Dr Steinbrook writes.

Limitations and Disclosures

Although this study showed an association between industry-paid benefits given to physicians in the form of meals and higher rates of brand-name prescriptions, it did not establish a cause-and-effect relationship between them. 

References

  1. DeJong C, Aguilar T, Tseng C, Lin GA, Boscardin W, Dudley R. Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries. JAMA Intern Med. 2016. Published online ahead of print June 20, 2016. doi:10.1001/jamainternmed.2016.2765.
  2. Steinbrook R. Industry Payments to Physicians and Prescribing of Brand-name Drugs. JAMA Intern Med. 2016. Published online ahead of print June 20, 2016.  doi:10.1001/jamainternmed.2016.2959.

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