Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing?

Mitchell, Aaron P.; Trivedi, Niti U.; Gennarelli, Renee L.; Chimonas, Susan; Tabatabai, Sara; Goldberg, Johanna; Díaz, Luis A.; Korenstein, Deborah

doi:10.7326/m20-5665

Cited by 156 publications

(195 citation statements)

References 106 publications

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“…Our study augments these results and found appreciable variation in physician payments observed across specialty, space, time, and type. Similar to prior studies, our findings also indicate that in order to fully understand macro trends in physician-industry relationships, careful contextualization of the types of payments received, the amounts and values that can potentially trigger COIs, and more detailed analysis of significant longitudinal or geographic shifts in spending is needed [ 24 ].…”

Section: Discussionsupporting

confidence: 79%

“…Additional research has also been conducted to further examine potential physician bias and conflicts of interest within particular specialty areas [ 21 – 23 ]. A recent systematic review also found that a large majority of studies found a positive association between industry payments and increased prescribing, including temporal and dose-response relationships [ 24 ]. Our study augments these results and found appreciable variation in physician payments observed across specialty, space, time, and type.…”

Section: Discussionmentioning

confidence: 99%

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Physicians payment in the United States between 2014 and 2018: An analysis of the CMS Open Payments database

et al. 2021

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The Open Payments database reports payments made to physicians by industry. Given the potential for financial conflicts of interest relating to patient outcomes, further scrutiny of these data is valuable. Therefore, the objective of this study was to analyze physician-industry relationships by specialty type, payment type, geospatial trend, and longitudinal trend between 2014–2018. We conducted an observational, retrospective data analysis of payments from the Open Payments database for licensed United States physicians listed in the National Plan & Provider Enumeration System (NPPES). Datasets from 2013–2018 were joined using the Python programming language. Aggregation and sub-setting by characteristics of interest was done in R to calculate means and frequencies of reported general physician payments from industry across different specialties, locations, timeframes, and payment types. Normalization was applied for numbers of physicians or payments. Geospatial statistical hot spot analysis was conducted in ArcGIS. 51.73 million payment records were analyzed. In total, 50,047,930 payments were issued to 771,113 allopathic or osteopathic physicians, representing $8,702,631,264 transferred from industry to physicians over the five-year period between 2014 and 2018. The mean payment amount was $179, with a standard deviation of $12,685. Variability in physicians’ financial relationships with industry were apparent across specialties, regions, time, and payment type. A limited match rate between records in the NPPES and Open Payments databases may have resulted in selection bias of trends related to physician characteristics. Further research is necessary, particularly in the context of changing industry payment trends and public perceptions of the appropriateness of these relationships.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Physicians payment in the United States between 2014 and 2018: An analysis of the CMS Open Payments database

et al. 2021

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“…Our analysis focused on "general payments," the term used by Open Payments to describe personal payments to physicians, because this is the form of payment that has been consistently identified as influencing physician prescribing behavior. 7,[9][10][11] . General payments include both direct cash transfers and in-kind gifts.…”

Section: Methodsmentioning

confidence: 99%

“…Receipt of payments is associated with increased prescribing, including among oncologists; physicians consistently prescribe more of a drug after they have received payments from its manufacturer. [3][4][5][6][7][8][9] The temporal association between payments and prescribing strongly suggest that this association is causal. 10,11 Physicians who have financial relationships with industry are more likely to recommend a company's drugs for formulary inclusion.…”

Section: Introductionmentioning

confidence: 99%

Personal Payments from Pharmaceutical Companies to Authors of Oncology Clinical Practice Guidelines

et al. 2021

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Background. Oncologists who author clinical practice guidelines frequently have financial relationships with the pharmaceutical industry. It is unknown whether participation on clinical practice guideline committees is associated with differences in the amounts of industry money received. Materials and Methods. We conducted a nested casecontrol study from August 2013-December 2018. We manually abstracted membership records of NCCN Guidelines committees for the 20 most common cancers and linked to Open Payments. The study sample included medical oncologists selected to join an NCCN Guidelines committee ("joiners") during the study period. Joiners were matched 1:2 to medical oncologists who had no participation on NCCN committees (controls) by gender, NCCN institution, and medical school graduation year. We performed difference-in-differences (DiD) estimation to assess whether selection to an NCCN committee was associated with the dollar value of payments received from industry, using generalized estimating equations to address correlation between matched pairs and between repeated observations of the same pair. Results. 54 physicians joined an NCCN Guidelines committee during the study period. These physicians received more payments than matched controls in the year prior to joining

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“…For example, financial conflicts on committees producing clinical practice guidelines tend to produce assessments of evidence and recommendations that favor the companies and industries involved ( Cosgrove et al, 2013 ; Lexchin 2020 ). In terms of medical practice, a recent systematic review shows that payments to physicians influence prescribing ( Mitchell et al, 2020 ). The broad issue of conflict of interest is important enough that the United States Institute of Medicine issued a detailed report on it, overwhelmingly about how financial conflicts involving industry affect researchers’ and physicians’ judgment ( Institute of Medicine, 2009 ).…”

Section: But Funding Is Rarely Just Fundingmentioning

confidence: 99%

Epistemic Corruption, the Pharmaceutical Industry, and the Body of Medical Science

Sismondo

2021

Front. Res. Metr. Anal.

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When a knowledge system importantly loses integrity, ceasing to provide the kinds of trusted knowledge expected of it, we can label this epistemic corruption. Epistemic corruption often occurs because the system has been co-opted for interests at odds with some of the central goals thought to lie behind it. There is now abundant evidence that the involvement of pharmaceutical companies corrupts medical science. Within the medical community, this is generally assumed to be the result of conflicts of interest. However, some important ways that the industry corrupts are not captured well by standard analyses in terms of conflicts of interest. It is not just that there is a body of medical science perverted by industry largesse. Instead, much of the corruption of medical science via the pharmaceutical industry happens through grafting activities: Pharmaceutical companies do their own research and smoothly integrate it with medical science, taking advantage of the legitimacy of the latter.

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Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing?

Cited by 156 publications

References 106 publications

Physicians payment in the United States between 2014 and 2018: An analysis of the CMS Open Payments database

Physicians payment in the United States between 2014 and 2018: An analysis of the CMS Open Payments database

Personal Payments from Pharmaceutical Companies to Authors of Oncology Clinical Practice Guidelines

Epistemic Corruption, the Pharmaceutical Industry, and the Body of Medical Science

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