The lack of a relationship between physician payments from drug manufacturers and Medicare claims for abiraterone and enzalutamide

Bandari, Jathin; Ayyash, Omar; Turner, Robert; Jacobs, Bruce L.; Davies, Ben

doi:10.1002/cncr.30914

Cited by 16 publications

(19 citation statements)

References 18 publications

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“…These results are consistent with an increasing body of literature finding an association between industry payments and physician prescribing behavior, across multiple medical specialties . Our results are also consistent with the finding that an association between industry payments and physician prescribing may be absent for prostate cancer drugs . The reason for the apparent difference between prostate cancer and other cancer types is an area for future study.…”

Section: Discussionsupporting

confidence: 91%

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

et al. 2019

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Background Financial relationships between physicians and the pharmaceutical industry are common, but factors that may determine whether such relationships result in physician practice changes are unknown. Materials and Methods We evaluated physician use of orally administered cancer drugs for four cancers: prostate (abiraterone, enzalutamide), renal cell (axitinib, everolimus, pazopanib, sorafenib, sunitinib), lung (afatinib, erlotinib), and chronic myeloid leukemia (CML; dasatinib, imatinib, nilotinib). Separate physician cohorts were defined for each cancer type by prescribing history. The primary exposure was the number of calendar years during 2013–2015 in which a physician received payments from the manufacturer of one of the studied drugs; the outcome was relative prescribing of that drug in 2015, compared with the other drugs for that cancer. We evaluated whether practice setting at a National Cancer Institute (NCI)‐designated Comprehensive Cancer Center, receipt of payments for purposes other than education or research (compensation payments), maximum annual dollar value received, and institutional conflict‐of‐interest policies were associated with the strength of the payment‐prescribing association. We used modified Poisson regression to control confounding by other physician characteristics. Results Physicians who received payments for a drug in all 3 years had increased prescribing of that drug (compared with 0 years), for renal cell (relative risk [RR] 1.81, 95% confidence interval [CI] 1.58–2.07), CML (RR 1.22, 95% CI 1.08–1.39), and lung (RR 1.69, 95% CI 1.58–1.82), but not prostate (RR 0.97, 95% CI 0.93–1.02). Physicians who received compensation payments or >$100 annually had increased prescribing compared with those who did not, but NCI setting and institutional conflict‐of‐interest policies were not consistently associated with the direction of prescribing change. Conclusion The association between industry payments and cancer drug prescribing was greatest among physicians who received payments consistently (within each calendar year). Receipt of payments for compensation purposes, such as for consulting or travel, and higher dollar value of payments were also associated with increased prescribing. Implications for Practice Financial payments from pharmaceutical companies are common among oncologists. It is known from prior work that oncologists tend to prescribe more of the drugs made by companies that have given them money. By combining records of industry gifts with prescribing records, this study identifies the consistency of payments over time, the dollar value of payments, and payments for compensation as factors that may strengthen the association between receiving payments and increased prescribing of that company's drug.

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Section: Discussionsupporting

confidence: 91%

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

et al. 2019

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“…A study of denosumab and degarelix for prostate cancer demonstrated only a weak association between payments and prescribing habits 9 . Similarly, an analysis of enzalutamide and abiraterone prescribing among urologists and oncologists found no relationship between receipt of payments and prescription counts 8 . These results differ from ours for several possible reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Prior analyses using OPP data have suggested that the receipt of industry payments is associated with increased prescribing costs for some patients 5 and increased prescribing of promoted oral anticoagulants, diabetes drugs, and intraocular anti-VEGF injections 6, 7 . Within urology, previous work has examined the association between payment and prescribing of drugs for prostate cancer 8, 9 . Contrary to studies in other fields, these studies found either a weak or no association between payments and prescribing.…”

Section: Introductionmentioning

confidence: 99%

The Receipt of Industry Payments is Associated With Prescribing Promoted Alpha-blockers and Overactive Bladder Medications

Modi

Wang

Kirk

et al. 2018

Urology

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“…However, studies in a variety of specialties and contexts have shown this to be untrue. 7,[20][21][22][23] Even small amounts of compensation, such as free meals, have been correlated to physician prescription of brand-name drugs, and payments from device companies have been associated with performance of specific procedures. 19 Industry certainly plays a key role in health care.…”

Section: Discussionmentioning

confidence: 99%

Increasing Industry Involvement in Otolaryngology: Insights from 3 Years of the Open Payments Database

Morse

Fujiwara

Mehra

2018

Otolaryngol.--head neck surg.

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Objectives To characterize industry payments to otolaryngologists in 2016 versus 2014 and 2015. Study Design Cross-sectional retrospective analysis. Setting Open Payments Database. Subjects and Methods Using the Open Payments Database, we identified otolaryngologists receiving payments from industry sponsors from 2014 to 2016. We characterized the number and value of payments per physician overall and by census region, as well as by sponsor subspecialty and payment type. Study years were compared via analysis of variance and Kruskal-Wallis tests. Trends in payments to otolaryngologists were compared with trends in 21 other specialties. Results Payment to otolaryngologists increased 67% from 2014 to 2016-from $8.7 million in 2014 to $9.9 and $14.5 million in 2015 and 2016, respectively ( P < .001). While mean payment per compensated otolaryngologist increased ($1095, $1243, and $1834 in 2014, 2015, and 2016, respectively, P < .001), median payments stayed relatively constant ($169, $165, and $172), suggesting an increasingly unequal distribution. Much of the increase is accounted for by an increased number of payments for consulting fees and physician ownership. Most payments were made by companies specializing in rhinology. Otolaryngology received the lowest industry compensation per physician among the surgical specialties examined and lower compensation than most nonsurgical specialties. The increase in payments to otolaryngologists was proportionally greater than all but 1 of the other 21 specialties examined. Conclusions Industry compensation to otolaryngologists is increasing and increasingly unequal, although it is still less than that in most other specialties. In otolaryngology, the Open Payments Database has not decreased physician-industry relationships as intended.

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The lack of a relationship between physician payments from drug manufacturers and Medicare claims for abiraterone and enzalutamide

Cited by 16 publications

References 18 publications

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

The Receipt of Industry Payments is Associated With Prescribing Promoted Alpha-blockers and Overactive Bladder Medications

Increasing Industry Involvement in Otolaryngology: Insights from 3 Years of the Open Payments Database

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