Approximately 65 percent of U.S. patients visit doctors who have received payments from pharmaceutical companies, a Drexel University study found. Only 5 percent of the 3,500 patients surveyed were aware that drug companies had made payments to their physicians.
The study was authored by Genevieve Pham-Kanter, PhD, a faculty member at Drexel’s Dornsife School of Public Health, in collaboration with researchers from Harvard and Stanford. The researchers surveyed individuals who had seen a doctor over the last 12 months and found that two-thirds of those physicians have received some form of financial incentive or gift from drug or medical device makers.
The research was published in the authoritative Journal of General Internal Medicine. According to Pham-Kanter, "Patients should be aware of the incentives that their physicians face that may lead them to not always act in their patients’ best interest. And the more informed patients are about their providers and options for care, the better decisions they can make.”
Pham-Kanter and her collaborators cross-referenced data from their survey with information (now publicly available on the Open Payments website), which lists payments made by the pharma industry to U.S. doctors. The site was created after the Affordable Care Act was passed, based on a provision titled the Physician Payment Sunshine Act.
When the researchers conducted their survey in late 2014, Open Payments was not yet fully active. Still, the investigative journalism site Pro Publica had already released information about which companies had paid which doctors in several states, including Minnesota and Massachusetts. This information was often obtained from companies who had to release it as part of settlement agreements. In other cases, the drug and device makers offered it voluntarily as the public demanded more transparency from the sector.
The study revealed that some specialists are more likely to have received payments from companies that make drugs and devices they may be incentivized to prescribe. For instance, 85 percent of orthopedic surgeon visits involved a specialist who had been paid by the industry, whereas 77 of the obstetricians or gynecologists mentioned in the survey had received payments.
According to Stanford´s Michelle Mello, one of Pham-Kanter´s co-authors, pharmaceutical companies “have long known that even small gifts to physicians can be influential.” Recent research has shown that reciprocity is usually encouraged.
The median payment received by the doctors visited by survey participants was $510. While this is not a vast number, we must not forget that fraud cases have emerged repeatedly, where big pharma paid doctors hundreds of thousands of dollars per year to induce prescriptions.
Perhaps the study´s most relevant aspect has to do with just how pervasive the practice is. More studies are needed to analyze the impact of drug company payments on physicians’ treatment and prescription decisions.