Doctors Given Meals by Drug Makers Prescribed More of Their Pills

Doctors who were fed meals costing even less than $20 later prescribed certain brand-name pills more often than rival medicines, according to a new analysis published on Monday of a federal database. And in most cases, costlier meals were associated with still higher prescribing rates for Medicare Part D drugs made by the same companies that provided the food. The findings, published in JAMA Internal Medicine, are likely to intensify an ongoing debate over the extent to which ties between drug makers and doctors unduly influence medical practice and the nation’s health care costs. The issue has resonated over the years as prices for prescription medicines continue to rise, and many drug companies have paid civil and criminal fines for illegal marketing and kickbacks designed to boost prescribing.

“High rates of brand-name prescribing are a pressing issue for patients and taxpayers,” said Colette DeJong, a coauthor and research fellow at the Center for Healthcare Value at the University of California, San Francisco School of Medicine. She noted there were “great generic options” that physicians could have prescribed instead. “This is a huge issue for seniors receiving Medicare, who pay a median copay of $1 for generics and $80 for nonpreferred brand-name drugs [which cost patients more since insurers provide less coverage for these medicines]. Multiply this by 10 monthly medications, and it can become unaffordable for people to pick up the medicine they need,” DeJong said.

The study examined more than 63,500 payments made to nearly 280,000 doctors, nearly 95 percent of which were meals that cost between $12 and $18 each, and took place at restaurants, meetings, and physician offices. They also identified physicians who received meals promoting the most-prescribed brand-name drug in each class of medicine for treating high cholesterol, high blood pressure, depression, irregular heartbeats, and heart failure. The researchers analyzed data from the federal Open Payments program for the last five months of 2013, which was the first batch of data that was posted by the Obama administration. They also looked at prescribing data for individual doctors from Medicare Part D. Industry-sponsored meals, by the way, accounted for about 80 percent of the total number of industry payments to physicians...