Wednesday, March 14, 2018

The more opioids doctors prescribe, the more money they make from pharmaceutical companies, analysis says

"As tens of thousands of Americans die from prescription opioid overdoses each year, an exclusive analysis by CNN and researchers at Harvard University found that opioid manufacturers are paying physicians huge sums of money -- and the more opioids a doctor prescribes, the more money he or she makes," Aaron Kessler, Elizabeth Cohen and Katherine Grise report for CNN.

In 2014 and 2015 opioid manufacturers paid hundreds of doctors fees for speaking, consulting or other services. Hundreds of doctors were paid six-figure sums, and thousands were paid more than $25,000. The doctors who prescribed particularly large amounts of opioids were the most likely to be paid consulting fees. It wasn't clear whether the payments encouraged the doctors to prescribe a company's opioid, or whether the pharmaceutical companies are finding and rewarding doctors who already prescribe large amounts of their opioids.

"It smells like doctors being bribed to sell narcotics, and that's very disturbing," said Dr. Andrew Kolodny, a senior scientist at the Institute for Behavioral Health at Brandeis University, where he co-directs the Opioid Policy Research Collaborative.

The analysis was done primarily by comparing two federal government databases: one that tracks payments drug companies give to doctors, and one that tracks prescriptions doctors write to Medicare recipients. During the period studied, more than 811,000 doctors wrote prescriptions to Medicare patients, and almost half of those doctors wrote at least one opioid prescription. Of the doctors who wrote at least one prescription for opioids, 54 percent received a payment from pharmaceutical companies that make opioids.

CNN graph; click the image to enlarge it.
"Doctors were more likely to get paid by drug companies if they prescribed a lot of opioids -- and they were more likely to get paid a lot of money," CNN reports. "Among doctors in the top 25th percentile of opioid prescribers by volume, 72 percent received payments. Among those in the top fifth percentile, 84 percent received payments. Among the very biggest prescribers -- those in the top 10th of 1 percent -- 95 percent received payments." The more opioids doctors prescribed, the more money they received. The top 10th of 1 percent received, on average, nine times more money than the typical doctor.

Paying doctors for speaking and consulting is legal, but controversial--and common. "Pharmaceutical company payments to doctors are not unique to opioids. Drug companies pay doctors billions of dollars for various services. In 2015, 48% of physicians received some pharmaceutical payment," CNN reports. Giving doctors kickback payments in exchange for prescribing certain drugs is illegal, though. Purdue Pharma, which has been under increasing scrutiny for its aggressive marketing practices for opioids OxyContin, Butrans and Hysingla, stopped paying doctors for promotional activities in 2016.

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