Chicago – A study released by the JAMA Internal Medicine journal says that doctors who accept free meals from the pharmaceutical industry feel inclined to prescribe a drug, even when is more expensive than the generic option.
The study used data from 63 thousand pharmaceutical company payments to 280 thousand doctors from August to December 2013. The study considered physicians in the Medicare’s prescription drug program.
The results of the study show that doctors who received food “incentives” are more likely to prescribe brand-name drugs from the Medicare Part D program. The study’s lead author is Dr. Adams Dudley, the director of the Center for Health Value at the University of California at San Francisco.
According to U.S. News and World Report, Dr. Dudley says this fact it is not medically harmful to patients but is costing them more.
One of the study’s authors, Colette Dejong, stated that it was believed that it took significant amounts of money to influence a doctor. She says what is most surprising to her is that small payments can make a big difference when it comes to prescribed drugs.
Typically, industry-sponsored meals cost less than $20, and the study says the rates of doctors prescribing brand-related drugs increased as the number of sponsored meals grew.
The research evaluated five branded drugs: Pristiq, which treats depression; Crestor, that treats high cholesterol; Benicar and Bystolic for high blood pressure; and Crestor for cholesterol problems.
According to the study, doctors who received no free meals were less likely to prescribe a branded drug than physicians who did take free meals. Physicians who did receive meals paid by the industry are inclined to prescribe their drugs.
The study shows that doctors who received four or more free meals prescribed Pristiq 3.4 times more than the doctors receiving zero sponsored meals. With Crestor, the rate was at 1.8 times and with Benicar at a 4.5 ratio.
The study resulted in an association to this phenomenon and the prescriptions of branded drugs, but it does not show a cause-and-effect relationship between free meals and branded drug prescriptions.
Patients typically pay 4 dollars or less for generics, and some non-generic drugs can cost over $40
The head of the ethics program of the Global Institute for Public Health at New York University, Arthur Caplan, says that even a small cheap gift can influence a physician’s decision drastically when prescribing drugs.
The Pharmaceutical Research and Manufacturers of America say that “educational items” have a voluntary code set to a $100 limit, and that occasional modest meals are permitted, U.S. News and World Report reports.
Regarding this subject, the American Medical Association voluntary ethics guidelines state that doctors should not accept any gift from the pharmaceutical industry because reciprocity is expected or implied.
U.S. News and World Report says that, according to e-mails sent by the companies involved in the study, free meals just favor communication with doctors and they are an important part of their educational methods when discussing drugs benefits and risks. The e-mails say that doctors are not being paid to prescribe their drugs.
Source: Wall Street Journal
One of the many reasons I don’t trust doctors any more than I trust used car salesmen.