Even Small Gifts Can Affect How Doctors Prescribe Opioids

By Kelly Burch 05/21/18

A new study found that receiving a free lunch from pharmaceutical companies was linked to an increase in opioid prescribing. 

Image: 
doctor holding a prescription

Receiving even a small amount of valued goods including money, free meals or speaking fees from pharmaceutical companies can influence how likely a doctor is to prescribe opioid medications, according to a new study.

The study, published in the Journal of the American Medical Association, found that research strongly suggests that payments from prescription drug companies impact how many opioids doctors prescribe, according to NBC News.

The study also found that doctors who prescribe the most opioids get the most money from pharmaceutical companies. 

“Amidst national efforts to curb the overprescribing of opioids, our findings suggest that manufacturers should consider a voluntary decrease or complete cessation of marketing to physicians,” lead study author Dr. Scott Hadland of Boston Medical Center wrote. “Federal and state governments should also consider legal limits on the number and amount of payments.”

The study used data that showed payments made during 2014, and compared it to opioids prescribed to Medicare patients the following year. Of the 370,000 physicians who prescribed opioids, 7%, or about 26,000, received some kind of payment that wasn’t related to research. A small amount, 436 doctors, received more than $1,000. 

The study showed that even getting a free lunch from the pharmaceutical companies was correlated with an increase in opioids prescribed the following year. 

“Each meal received in 2014 was associated with an increasing number of opioid claims in 2015,” researchers wrote. 

The correlation does not prove that payments affect prescribing, researchers noted. For example, it might be the case that doctors who prescribe the most opioids have more expertise, and thus are sought out by drug manufacturers to attend events. 

However, the research showed that Insys Therapeutics, which makes a fentanyl spray, spent the most money on gifts to doctors during 2014. Insys spent $4.5 million, compared with $800,000 spent by both Teva Pharmaceuticals and Janssen Pharmaceuticals, the second and third highest spenders. 

Insys is now part of a federal corruption investigation. Former executives from the company have been charged, with federal prosecutors alleging that they bribed doctors to prescribe Subsys, a fentanyl spray, to patients that didn’t need such a powerful drug.

Federal authorities have also indicted at least five doctors for taking “speaking fees” from Insys. However, these were reportedly kickbacks paid to the doctors who attended parties hosted by the company but did not lecture at the events. 

The company says that it has drastically changed its practices. 

"The number of Insys-hosted physician speaker programs related to Subsys and the amount in honoraria paid to those physician speakers went down by 87% and 82%, respectively, in 2017 compared to 2015," a spokesman told NBC by email. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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