Alí Duarte-García1, Cynthia S Crowson2, Rozalina G McCoy3, Jeph Herrin4, Veronica Lam5, Michael S Putman6, Joseph S Ross7, Eric L Matteson8, Nilay D Shah9. 1. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN. Electronic address: duarte.ali@mayo.edu. 2. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN. 3. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN. 4. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Flying Buttress Associates, Charlottesville, VA. 5. Flying Buttress Associates, Charlottesville, VA. 6. Division of Rheumatology, Department of Medicine, Medical College of Wisconsin, Milwaukee. 7. Section of General Internal Medicine and the National Clinician Scholars Program, Department of Medicine, Yale School of Medicine Department of Health Policy and Management, Yale School of Public Health and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT. 8. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN. 9. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVE: To evaluate the association between pharmaceutical industry payments to rheumatologists and their prescribing behaviors. METHODS: A cross-sectional analysis was conducted of Medicare Part B Public Use File, Medicare Part D Public Use File, and Open Payments data for 2013 to 2015. Prescription drugs responsible for 80% of the total Medicare pharmaceutical expenditures in rheumatology were analyzed. We calculated the mean annual drug cost per beneficiary per year, the percentage of rheumatologists who received payments, and the median annual payment per physician per drug per year. Industry payments were categorized as food/beverage and consulting/compensation. Multivariable regression models were used to assess associations between industry payments and both prescribing patterns and prescription drug expenditures. RESULTS: Of 4822 rheumatologists in the Medicare prescribing databases, 3729 received any payment from a pharmaceutical company during this time frame. Food/beverage payments were associated with an increased proportion of prescriptions for the related drugs (range, 1.5% to 4.5%) and an increased proportion of annual Medicare spending for the related drugs (range, 3% to 23%). For every $100 in food/beverage payments, the probability of prescribing increased (range, 1.5% to 14% for most drugs) and Medicare reimbursements increased (range, 6% to 44% for most drugs). Consulting/compensation payments were associated with an increased proportion of prescriptions (range, 1.2% to 1.6%) and an increased proportion of annual Medicare spending (range, 1% to 2%). For every $1000 in consulting/compensation payments, both the probability of prescribing increased (5% or less for most drugs) and Medicare reimbursements increased (less than 10% for most drugs). CONCLUSION: Payments to rheumatologists by pharmaceutical companies are associated with increased probability of prescribing and Medicare spending.
OBJECTIVE: To evaluate the association between pharmaceutical industry payments to rheumatologists and their prescribing behaviors. METHODS: A cross-sectional analysis was conducted of Medicare Part B Public Use File, Medicare Part D Public Use File, and Open Payments data for 2013 to 2015. Prescription drugs responsible for 80% of the total Medicare pharmaceutical expenditures in rheumatology were analyzed. We calculated the mean annual drug cost per beneficiary per year, the percentage of rheumatologists who received payments, and the median annual payment per physician per drug per year. Industry payments were categorized as food/beverage and consulting/compensation. Multivariable regression models were used to assess associations between industry payments and both prescribing patterns and prescription drug expenditures. RESULTS: Of 4822 rheumatologists in the Medicare prescribing databases, 3729 received any payment from a pharmaceutical company during this time frame. Food/beverage payments were associated with an increased proportion of prescriptions for the related drugs (range, 1.5% to 4.5%) and an increased proportion of annual Medicare spending for the related drugs (range, 3% to 23%). For every $100 in food/beverage payments, the probability of prescribing increased (range, 1.5% to 14% for most drugs) and Medicare reimbursements increased (range, 6% to 44% for most drugs). Consulting/compensation payments were associated with an increased proportion of prescriptions (range, 1.2% to 1.6%) and an increased proportion of annual Medicare spending (range, 1% to 2%). For every $1000 in consulting/compensation payments, both the probability of prescribing increased (5% or less for most drugs) and Medicare reimbursements increased (less than 10% for most drugs). CONCLUSION: Payments to rheumatologists by pharmaceutical companies are associated with increased probability of prescribing and Medicare spending.
Authors: John P A Ioannidis; Fotini B Karassa; Eric Druyts; Kristian Thorlund; Edward J Mills Journal: Nat Rev Rheumatol Date: 2013-09-03 Impact factor: 20.543
Authors: Scott E Hadland; Magdalena Cerdá; Yu Li; Maxwell S Krieger; Brandon D L Marshall Journal: JAMA Intern Med Date: 2018-06-01 Impact factor: 21.873
Authors: Colette DeJong; Thomas Aguilar; Chien-Wen Tseng; Grace A Lin; W John Boscardin; R Adams Dudley Journal: JAMA Intern Med Date: 2016-08-01 Impact factor: 21.873
Authors: Haiden A Huskamp; Patricia A Deverka; Arnold M Epstein; Robert S Epstein; Kimberly A McGuigan; Richard G Frank Journal: N Engl J Med Date: 2003-12-04 Impact factor: 91.245
Authors: Jie Zhang; Fenglong Xie; Elizabeth Delzell; Lang Chen; Meredith L Kilgore; Huifeng Yun; Kenneth G Saag; James D Lewis; Jeffrey R Curtis Journal: Arthritis Care Res (Hoboken) Date: 2013-11 Impact factor: 4.794
Authors: William Fleischman; Shantanu Agrawal; Marissa King; Arjun K Venkatesh; Harlan M Krumholz; Douglas McKee; Douglas Brown; Joseph S Ross Journal: BMJ Date: 2016-08-18