The Effects of Pharmaceutical Firm Enticements on Physician Prescribing Patterns

Orlowski, James P.; Wateska, Leon P.

doi:10.1378/chest.102.1.270

Cited by 338 publications

(178 citation statements)

References 11 publications

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“…Although orthopaedic surgeons maintain strong ties with device manufacturers owing to the need for physician input in the development of new and innovative surgical devices, previous analyses of the Sunshine act data revealed a large difference between the field and others. While previous research has shown that industry payments may affect provider practices [3,4,10,18,21,30,40] and patient perceptions of their physicians [32,48], our study showed that substantial disparities in payments do exist among orthopaedic surgeons and that the median orthopaedic surgeon does not receive a large sum. The majority of total payments to orthopaedic surgeons are for royalties and licenses for intellectual property, which actually foster device innovations and are viewed more positively by patients and physicians [8].…”

Section: Discussioncontrasting

confidence: 75%

Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data

Samuel

Webb

Lukasiewicz

et al. 2015

Clin Orthop Relat Res

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Background Industry payments made to physicians by drug and device manufacturers or group purchasing organizations are now reported to the Centers for Medicare and Medicaid Services (CMS) as a part of the Physician Payments Sunshine Act. Initial reports from the program show that orthopaedic surgeons lead all physician specialties in total and average industry payments. However, before further discussion of these payments and their implications can take place, it remains to be seen whether these figures are a true reflection of the field of orthopaedic surgery in general, rather than the result of a few outlier physicians in the field. In addition, the nature and sources of these funds should be determined to better inform the national dialogue surrounding these payments.

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Section: Discussioncontrasting

confidence: 75%

Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data

Samuel

Webb

Lukasiewicz

et al. 2015

Clin Orthop Relat Res

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“…For 2 scenarios, residents were more likely to report using drug samples than attendings ( P Ͻ .05). When respondents who chose a drug sample for 2 or 3 scenarios were compared to those who never chose to use a drug sample, or D rug advertising has been shown to affect physicians' prescribing behaviors, [1][2][3] with an estimated $12 billion a year spent on drug advertising and marketing. 4 Pharmaceutical companies currently use a multifaceted approach to drug promotion, incorporating techniques such as hospital and office detailing by pharmaceutical representatives, direct-to-consumer advertising through television and magazines, and printed materials in journals.…”

Section: Measurements and Main Resultsmentioning

confidence: 99%

A physician survey of the effect of drug sample availability on physicians’ behavior

et al. 2000

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OBJECTIVE: Pharmaceutical companies often use drug samples as a marketing strategy in the ambulatory care setting. Little is known about how the availability of drug samples affects physicians' prescribing practices. Our goal was to assess: (1) under what circumstances and why physicians dispense drug samples, (2) if drug samples lead physicians to use medications other than their preferred drug choice, and (3) the physician characteristics that are associated with drug sample use. DESIGN:Cross-sectional survey. SETTING:University-based clinics at one academic medical center.PARTICIPANTS: 154 general medicine and family physicians. MEASUREMENTS AND MAIN RESULTS:Physicians' selfreported prescribing patterns for 3 clinical scenarios, including their preferred drug choice, whether they would use a drug sample and subsequently prescribe the sampled medication, and the importance of factors involved in the decision to dispense a drug sample. A total of 131 (85%) of 154 physicians responded. When presented with an insured woman with an uncomplicated lower urinary tract infection, 22 (17%) respondents reported that they would dispense a drug sample; 21 (95%) of 22 sample users stated that they would dispense a drug sample that differed from their preferred drug choice. For an uninsured man with hypertension, 35 (27%) respondents reported that they would dispense a drug sample; 32 (91%) of 35 sample users indicated that they would dispense a drug sample instead of their preferred drug choice. For an uninsured woman with depression, 108 (82%) respondents reported that they would dispense a drug sample; 53 (49%) of 108 sample users indicated that they would dispense a drug sample that differed from their preferred drug choice. Avoiding cost to the patient was the most consistent motivator for dispensing a drug sample for all 3 scenarios. For 2 scenarios, residents were more likely to report using drug samples than attendings ( P Ͻ .05). When respondents who chose a drug sample for 2 or 3 scenarios were compared to those who never chose to use a drug sample, or chose a drug sample for only one scenario, only younger age was independently associated with drug sample use. CONCLUSION:In self-reports, the availability of drug samples led physicians to dispense and subsequently prescribe drugs that differ from their preferred drug choice. Physicians most often report using drug samples to avoid cost to the patient.

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“…Pharmaceutical companies for example sponsor for physicians, all-expenses-paid "conference trips" to attractive resort. These practices it is argued significantly increase the prescribing of the promoted drugs (Orlowski and Wateska 1992). A company that maintains ski lodges and seaside villas for VIP suppliers and clients, or a property developer who invites officials responsible for approving construction, to a lavish lunch follow the very similar pattern.…”

Section: Bribery As Policymentioning

confidence: 97%

Gift Giving and Corruption

Graycar

Jancsics

2016

International Journal of Public Administration

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When individuals exchange gifts social bonds are strengthened and reciprocity is created. If the gift and the reciprocation both come from private resources it is clearly a gift. If what is reciprocated after a gift is given comes from an organization, or is a government resource rather than from "one's own pocket" then it is most likely a bribe. The key variable is not the value of the gift but the transparency of the transaction. What has occurred is the trading of entrusted authority. This is corruption, and a serious danger to public policy.This study reviews anthropological literature on gift giving, and constructs a typology for the examining the gift/ bribe distinction in public administration. This classification helps to distinguish analytically among different types of gift practice and clarify conceptual ambiguity of the terms gift and bribe.

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The Effects of Pharmaceutical Firm Enticements on Physician Prescribing Patterns

Cited by 338 publications

References 11 publications

Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data

Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data

A physician survey of the effect of drug sample availability on physicians’ behavior

Gift Giving and Corruption

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