Financial Payments to Teaching Hospitals by Companies Marketing Opioids

Anderson, Timothy S.; Krieger, Maxwell S.; Marshall, Brandon D. L.; Cerdá, Magdalena; Hadland, Scott E.

doi:10.1007/s11606-019-05596-1

Cited by 7 publications

(11 citation statements)

References 3 publications

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“…Financial CoIs of healthcare academic institutions, including teaching hospitals, can compromise integrity of research, education, and patient care 119‐121 . Of 58 teaching hospitals examined in the United States, 5.8% received opioid‐related payments 120 .…”

Section: Category III Organizations: Important But Indirect Influencersmentioning

confidence: 99%

“…The USA's Federation of State Medical Boards (FSMB), which was involved in producing opioid use guidelines, also received grants from Purdue Pharma. 2,636.2 | Academic institutionsFinancial CoIs of healthcare academic institutions, including teaching hospitals, can compromise integrity of research, education, and patient care [119][120][121]. Of 58 teaching hospitals examined in the United States, 5.8% received opioid-related payments 120.…”

mentioning

confidence: 99%

“…2,636.2 | Academic institutionsFinancial CoIs of healthcare academic institutions, including teaching hospitals, can compromise integrity of research, education, and patient care [119][120][121]. Of 58 teaching hospitals examined in the United States, 5.8% received opioid-related payments 120. Prestigious universities and academic centres in the United States and one in Canada received grants/donations from opioid companies and, in one instance, privately from the Sackler family (Purdue Pharma); monies were used to create and fund a graduate school, pain centres, Management of chronic pain is complex and requires comprehensive biopsychosocial assessment, timely and affordable multi-disciplinary care, including non-pharmacologic management and long-term followup.…”

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confidence: 99%

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The iatrogenic opioid crisis: An example of ‘institutional corruption of pharmaceuticals’?

Makhinson

Seshia

Young

et al. 2021

Evaluation Clinical Practice

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Rationale Prescribed opioids are major contributors to the international public health opioid crisis. Such widespread iatrogenic harms usually result from collective decision failures of healthcare organizations rather than solely of individual organizations or professionals. Findings from a system‐wide safety analysis of the iatrogenic opioid crisis that includes roles of pertinent healthcare organizations may help avoid or mitigate similar future iatrogenic consequences. In this retrospective exploratory study, we report such an analysis. Methods The study population encompassed the entire age spectrum and included those in whom opioids prescribed for chronic pain (unrelated to malignancy) were associated with death or morbidity. Root cause analysis, incorporating recent suggestions for improvement, was used to identify possible contributory factors from the literature. Based on their mandated roles and potential influences to prevent or mitigate the iatrogenic crisis, relevant organizations were grouped and stratified from most to least influential. Results The analysis identified a chain of multiple interrelated causal factors within and between organizations. The most influential organizations were pharmaceutical, political, and drug regulatory; next: experts and their related societies, and publications. Less influential: accreditation, professional licensing and regulatory, academic and healthcare funding bodies. Collectively, their views and decisions influenced prescribing practices of frontline healthcare professionals and advocacy groups. Financial associations between pharmaceutical and most other organizations/groups were common. Ultimately, patients were adversely affected. There was a complex association with psychosocial variables. Limitations The analysis suggests associations not causality. Conclusion The iatrogenic crisis has multiple intricately linked roots. The major catalyst: pervasive pharma‐linked financial conflicts of interest (CoIs) involving most other healthcare organizations. These extensive financial CoIs were likely triggers for a cascade of erroneous decisions and actions that adversely affected patients. The actions and decisions of pharma ranged from unethical to illegal. The iatrogenic opioid crisis may exemplify ‘institutional corruption of pharmaceuticals’.

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Section: Category III Organizations: Important But Indirect Influencersmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

The iatrogenic opioid crisis: An example of ‘institutional corruption of pharmaceuticals’?

Makhinson

Seshia

Young

et al. 2021

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…30 Additionally, these payments to physicians increase healthcare costs 31 and prescriptions of drugs, with less safety and lower effectiveness. [32][33][34][35][36][37] A recent systematic review proved that payments in uence physician clinical practices. 38 Non-research payments may be harmful to patients, since these decrease the patient's ability to make independent therapeutic decisions.…”

Section: Discussionmentioning

confidence: 99%

Industry payments to pediatricians in the United States between 2013 and 2021

Murayama

2023

Preprint

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Objectives To evaluate the extent of research and non-research industry payments to pediatricians over a nine-year period between 2013 and 2021. Study design Using the general and research payments from the Open Payments Database between 2013 and 2021, this cross-sectional analysis examined the industry payments made to physicians whose primary specialty was pediatrics in the National Plan and Provider Enumeration System. Descriptive analyses were performed for the payment data overall and other pediatrician demographics. Trends in industry payments were analyzed by generalized estimating equation models. Results Of 99,764 pediatricians, 59,984 (60.1%) received a total of $297 million (12.8%) in general and $2 billion in associated research payments over the nine years. Median nine-year per-physician payments were $288 (interquartile range [IQR]: $88-958) in general and $65,343 (IQR: $16,763-255,208) in associated research payments. Pediatric allergists and immunologists received the highest per-physician median payments ($1,565), followed by pediatric endocrinologists ($1,368) and pediatric transplant hepatologists ($1,006). Male pediatricians were 1.06 (95% confidence interval [CI]: 1.05-1.09, p<0.001), 1.92 (95% CI: 1.73-2.13, p<0.001), and 1.56 (95% CI: 1.49-1.65, p<0.001) times more likely to receive general, direct research, and associated research payments than females, respectively. The number of pediatricians receiving general payments annually decreased by 1.5% (95% CI: -1.7% to -1.4%, p<0.001). Conclusions Most pediatricians received relatively small amounts of general payments and the number of pediatricians receiving the payments decreased annually.

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“…22,36 However, as demonstrated with brand-name colchicine in this study, a substantial body of evidence suggests that these promotional payments and educational events sponsored by the healthcare industry often result in the prescription of unnecessary and potentially harmful drugs over more affordable, cost-effective alternatives. 11,18,28,32,33,37,38 The ethical and financial consequences of these interactions cannot be overstated and warrant further scrutiny. Nevertheless, previous research has shown that physicians engaged in financial interactions with the healthcare industry tend to view these engagements more favorably than those who are not.…”

Section: Interpretations and Implicationsmentioning

confidence: 99%

Industry‐sponsored meal payments are associated with prescriptions and Medicare expenditures on brand‐name colchicine in the United States

Murayama

2023

Int J of Rheum Dis

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AimTo investigate the association between industry‐sponsored meal payments and the prescribing patterns of brand‐name colchicines, namely Colcrys and Mitigare, among Medicare beneficiaries in the United States from 2014 to 2021.MethodsThis cross‐sectional study utilized data from the Open Payments Database and Medicare Part D covering the years 2014 to 2021. The study included 54 836 physicians who submitted more than 10 colchicine claims. Exposure was defined as the receipt of one or more industry‐sponsored meals from the manufacturers of Colcrys or Mitigare. The primary outcomes included the likelihood of prescribing Colcrys and Mitigare, as well as the associated number of claims and Medicare expenditures.ResultsAmong 54 836 eligible physicians, 44.9% received meal payments from the Colcrys manufacturer, and 8.0% from the Mitigare manufacturer, over the eight‐year study period. The average meal payment value was $14.9 for Colcrys and $15.1 for Mitigare. The receipt of meal payments was significantly associated with an increased likelihood of prescribing Colcrys (odds ratio: 1.24 [95% CI: 1.21–1.27], p < .001) and Mitigare (odds ratio: 3.54 [95% CI: 2.98–4.20], p < .001). Each additional meal payment corresponded with a significant increase in Medicare expenditures: $55.4 (95% CI: $48.3–$62.5, p < .001) for Colcrys and $153.7 (95% CI: $17.7–$289.6, p = .03) for Mitigare. These associations remained consistent across different specialties and genders.ConclusionThis study reveals that receipt of meal payments from manufacturers of brand‐name colchicine was significantly associated with an increased rate of prescriptions for these brand‐name drugs, leading to higher Medicare expenditures in the United States.

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Financial Payments to Teaching Hospitals by Companies Marketing Opioids

Cited by 7 publications

References 3 publications

The iatrogenic opioid crisis: An example of ‘institutional corruption of pharmaceuticals’?

The iatrogenic opioid crisis: An example of ‘institutional corruption of pharmaceuticals’?

Industry payments to pediatricians in the United States between 2013 and 2021

Industry‐sponsored meal payments are associated with prescriptions and Medicare expenditures on brand‐name colchicine in the United States

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