Last July I wrote about a tool which would allow patients to see whether their doctors had received money from pharmaceutical companies. Here is a link to that post. At the time, I cautioned that there was no evidence such payments affected what doctors prescribed although I did point out that the drug companies must have thought that they were getting their money’s worth from the payments. Today there is evidence linking the payments to prescription patterns.
Pro Publica, a public interest group, reviewed the payments received by doctors from pharmaceutical companies and compared them to prescriptions written by those doctors for Medicare patients. Here is a link to their report, which was co-published with NPR, the Boston Globe and the Tampa Bay Times. While the data concerning prescriptions for Medicare patients is now available, similar data for prescriptions written to patients with private insurance is not. The assumption is that the patterns discovered apply to private insurance patients as well. The analysis showed that doctors who received money from drug and device makers, even if it was a small amount, tended to write a higher percentage of prescriptions for brand name medicines than doctors who did not receive these payments. Those who received payments were two to three times as likely to prescribe a brand name medication compared to other members of their specialty. Doctors who received more than $5,000.00 in 2014 had the highest rate of prescriptions of brand name products. This is important as there is often a generic medication which compares favorably to the brand name in both effectiveness and patient satisfaction.
The percentage of doctors who receive such payments is high and widespread across the country. For example, nearly 9 in 10 cardiologists who wrote over 1,000 prescriptions for Medicare patients in 2014 received payments. One observer remarked that a doctor almost had to go out of his or her way to avoid taking money from the drug and device makers.
Whether this is a problem or not remains the subject of debate. What is clear, however, is that the practice of writing brand name prescriptions costs the public at least hundreds of millions of dollars each year compared to the price of comparable generics. Whether you have health insurance or not, the extra money spent on brand name medications, which often cost two or three times more than a comparable generic, is costing you money. Ask your provider whether there is a generic substitute for a brand name medication he or she wants to order for you.
