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Free Meals for Doctors by Drug Cos influence their prescriptions : JAMA Study


Free Meals for Doctors by Drug Cos influence their prescriptions : JAMA Study

 In this cross-sectional study of 279669 physicians, physicians who received a single meal promoting the drug of interest, with a mean value of less than $20, had significantly higher rates of prescribing rosuvastatin as compared with other statins; nebivolol as compared with other β-blockers; olmesartan as compared with other angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers; and desvenlafaxine as compared with other selective serotonin and serotonin-norepinephrine reuptake inhibitors.

Is a Physician’s stomach the way to his prescription pad?

The answer would be yes, if the results of a new study are to be believed. A study Published in JAMA Internal Medicine this week, clearly revealed that medical practitioners seem to be falling for the so called “ free lunches” that are offered by pharma companies. More surprisingly the results of the study also reveal that these are not  the so-called “fancy lunches” and decision-making of doctors can be influenced by meals with mean value of less than $20.

The study focused on 279,699 physicans in the US who were prescribing primarly four classes of drug prescriptions to medicare patients including statins, cardioselective β-blockers, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers (ACE inhibitors and ARBs), and selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs and SNRIs ). The authors  identified physicians who received industry-sponsored meals promoting the most-prescribed brand-name drug in each class (rosuvastatin, nebivolol, olmesartan, and desvenlafaxine, respectively).

The purpose, simple, to study the  Prescribing rates of promoted drugs compared with alternatives in the same class, after adjustment for physician prescribing volume, demographic characteristics, specialty, and practice setting.

The authors found the following results:-

  • A total of 279 669 physicians received 63 524 payments associated with the 4 target drugs. Ninety-five percent of payments were meals, with a mean value of less than $20.
  • Rosuvastatin represented 8.8% of statin prescriptions; nebivolol represented 3.3% of cardioselective β-blocker prescriptions; olmesartan represented 1.6of ACE inhibitor and ARB prescriptions; and desvenlafaxine represented 0.6% of SSRI and SNRI prescriptions.
  • Physicians who received a single meal promoting the drug of interest had higher rates of prescribing rosuvastatin over other statins nebivolol over other β-blockers olmesartan over other ACE inhibitors and, and desvenlafaxine over other SSRIs and SNRIs .
  • Receipt of additional meals and receipt of meals costing more than $20 were associated with higher relative prescribing rates.

During Discussion, however, the authors called this to be an association and did not establish a cause an effect relationship

 The policy implications of our findings thus depend on further clarification of the mechanism of the association between the receipt of industry-sponsored meals and physician prescribing behavior.

  • If events where industry-sponsored meals are provided affect prescribing by informing physicians about new evidence and clinical guidelines, then the receipt of sponsored meals may benefit patient care.
  • If physicians, however, choose to attend industry events where information is provided about drugs they already prefer, then meals may have no affect on prescribing patterns.
  • If, alternatively, meals change physicians’ prescribing practices as a result of promotional influence, either by encouraging future use or rewarding an ongoing preference for the promoted drug, this would be cause for concern.

The authors then concluded

The receipt of industry-sponsored meals was associated with an increased rate of prescribing the promoted brand-name medication relative to alternatives within the drug class. The findings represent an association, not a cause-and-effect relationship.

 

You can read the full study by clicking on the following link

Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries By-Colette DeJong, BA; Thomas Aguilar, MS; Chien-Wen Tseng, MD, MPH; Grace A. Lin, MD, MAS; W. John Boscardin, PhD; R. Adams Dudley, MD, MBA

 

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Meghna Singhania
Meghna A Singhania is the founder and Editor-in-Chief at Medical Dialogues. An Economics graduate from Delhi University and a post graduate from London School of Economics and Political Science, her key research interest lies in health economics, and policy making in health and medical sector in the country. She can be contacted at meghna@medicaldialogues.in. Contact no. 011-43720751
Source: JAMA Internal Medicine

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  1. user
    Dr Sunny MBBS MD (MAMC) June 8, 2018, 10:28 pm

    None of the authors seems to be a practicing doctor with real interest to show truth. They forget that even during that lunch time the doctor is busy listening to a drug description which may benefit his patients, this is the only way busy practitioners gain knowledge and make progress
    In return for $20 meal, the doctor is giving his peace of mind and time worth many times the meal value. The lobbyists spend billions to get their points across to the lawmakers, how come a mere $20 is pinching these non practicing theoreticians.
    The doctors otherwise will not know about the drug and patients will be losing this advantage

  2. user
    Shilpa Agarwal May 21, 2018, 12:55 pm

    This is human nature and not just physician\’s. It\’s wrong or unwise to do this research only on docs.
    So unethical and inhumane study as it will further worsen the patient doc relationship

  3. I too agree with you. In India many of the corporate hospitals, perform operation for the profit. Everyone should have noticed this that near the/under the glass, the doctors keeps a list of medicine name.

  4. user
    narendra gemawat March 10, 2018, 6:09 pm

    Ssorry to read opinion which is in bad taste as well as unscientific .

  5. How can Research be unscientific?

  6. A meal merely does not influence Priscription writing by most doctors.Each doctor judges for himself what is best for that particular patient in terms of indication and cost.Only then is a rational prescription handed over.

  7. user
    dr Hamza Thayyil June 13, 2018, 10:20 am

    it seems doctor bashing has news value.Precious effort was spent on a useless finding.To generalise that a frugal meal is enough to trap a doctor is to say the least prepostrus and intimidatory.