overall than doctors who didn’t, our analysis
showed. Indeed, doctors who received industry payments were two to three times as likely
to prescribe brand-name drugs at exceptionally high rates as others in their specialty.
Doctors who received more than
$5,000 from companies in 2014 typically
had the highest brand-name prescribing percentages. Among internists who received no
payments, for example, the average brandname prescribing rate was about 20 percent,
compared to about 30 percent for those who
received more than $5,000.
ProPublica’s analysis doesn’t prove
industry payments sway doctors to prescribe
particular drugs, or even a particular company’s drugs. Rather, it shows that payments are
associated with an approach to prescribing
that, writ large, benefits drug companies’ bottom line.
“It again confirms the prevailing wisdom … that there is a relationship between
payments and brand-name prescribing,” said
Dr. Aaron Kesselheim, an associate professor
of medicine at Harvard Medical School who
provided guidance on early versions of ProPublica’s analysis. “This feeds into the ongoing
conversation about the propriety of these
sorts of relationships. Hopefully we’re getting past the point where people will say, ‘Oh,
there’s no evidence that these relationships
change physicians’ prescribing practices.’”
Numerous studies show that generics,
which must meet rigid Food and Drug Administration standards, work as well as name
brands for most patients. Brand-name drugs
typically cost more than generics and are
more heavily advertised. Although some medications do not have exact generic versions,
there usually is a similar one in the same category. In addition, when it comes to patient satisfaction, there isn’t much difference between
brands and generics, according to data collected by the website Iodine, which is building
a repository of user reviews on drugs.
There’s wide variation from state to
state when it comes to the proportion of prescribers who take industry money, our analysis
found. The rate in Nevada, Alabama, Kentucky
and South Carolina was twice as high as in
Vermont, Minnesota, Wisconsin and Maine.
But overall, payments are widespread.
Nationwide, nearly nine in 10 cardiologists
who wrote at least 1,000 prescriptions for
Medicare patients received payments from a
drug or device company in 2014, while seven
in 10 internists and family practitioners did.
For more information, go to
https://www.propublica.org/
(*You can read our methodology here:
https://static.propublica.org/projects/d4d/20160317-matching-industry-payments.pdf?22)
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