Study: Feeding a doc can hike opioid scripts
Even a $13 meal can affect an MD’s prescribing practice
It’s no secret that some physicians who receive thousands of dollars in consulting fees from pharma companies prescribe more opioids. But even as little as a $13 meal can lead to more reckless prescribing practices, according to a new study from Boston Medical Center.
“There’s been a lot written on pharmaceuticals and marketing to physicians, but a lot of the focus has been on these very large payments,” said Dr. Scott Hadland, lead author and addiction researcher at BMC’s Grayken Center.
“This paper was really looking at the other side of the coin: the very normalized practice of giving meals to physicians to promote opioid products.”
He added, “We found this widespread practice probably has the bigger public health effect.”
Hadland and his colleagues found that any type of opioid marketing in 2014 was associated with 9.3 percent more opioid claims in 2015, according to the paper out yesterday in the Journal of the American Medical Association.
The researchers looked at marketing exchanges in the Open Payments database and compiled information on all opioid-related payments to physicians, including speaking fees, consulting fees and meals.
They also gathered data from Medicare Part D claims.
The authors identified 369,139 physicians who prescribed opioids under Medicare Part D in 2015 — 7 percent of those receiving opioid-related pharmaceutical payments totaling $9,071,976.
Despite the national focus on massive payments to physicians, only 436 doctors — 1.7 percent of those receiving marketing — took payments greater than $1,000.
Ninety-two percent of opioid payments were in the form of meals, with a median value of $13. Prescriptions increased for each additional meal given.
“We may think of free meals as fairly innocuous, but in fact they do seem to have an impact,” said Brandon Marshall, co-author and associate professor of epidemiology at Brown University School of Public Health.
Marshall said these findings will hopefully lead to tighter regulations on these exchanges. States like New Jersey have passed legislation capping the annual limit of payments at a whopping $10,000.
“In terms of regulatory actions, we may want improved regulations over the number of interactions, not just the value,” Marshall said, “even right down to free lunch events.”