Drug Company Payments to Doctors Helped Fuel the Opioid Epidemic: Study

Drug Company Payments to Doctors Helped Fuel the Opioid Epidemic: Study

Research has established that over-prescribing of prescription opioids has been a major contributor to the out-of-control opioid epidemic in America. Most victims move from prescription to illicit opioids.

Opioid prescriptions are declining across the country. Heroin and fentanyl have taken over from prescription opioids as the major killers.

Now, a new study has found that, although prescriptions for opioid painkillers have been declining for several years, the opioid industry continues its marketing practice of cash gifts and other inducements to physicians, to encourage opioid prescribing.

Could that continue to fuel the epidemic by promoting more opioid prescribing?

It appears the answer may be yes.

Dr. Scott E. Hadland of Boston Medical Center's Grayken Center for Addiction recently assembled a team of researchers to see if opioid prescribing is influenced by drug company direct-to-physician marketing inducements.

The results of the study reveal that doctors who received cash and other inducements from the drug industry in 2014 wrote 9.3 percent more opioid prescriptions the following year (2015) than they did in 2014.

Conversely, doctors who were, well, let’s just say it – not bribed in 2014, wrote fewer opioid prescriptions in 2015 than they did a year earlier, the study said. This follows the national trend of declining opioid prescriptions.

Widespread Practice

“Pharmaceutical industry marketing to physicians is widespread,” the researchers said, “but it is unclear whether marketing of opioids influences prescribing. We studied the extent to which pharmaceutical industry marketing of opioid products to physicians during 2014 was associated with opioid prescribing during 2015.”

The study authors acknowledged the increasing impact of heroin and illicitly manufactured fentanyl on opioid-related overdose deaths. But, they said, 40 percent of deaths still involve prescription opioids.

“Prescription opioids are commonly the first opioid encountered in a trajectory toward illicit consumption,” they said. “Although opioid prescribing has declined nationally, rates in 2015 were triple those in 1999 and remain elevated in regions of the country with higher numbers of overdoses.”

The Study

The study was published in the Journal of the American Medical Association (JAMA). Opioid industry marketing inducements in 2014 included:

  • $6,156,757 for “speaking fees and/or honoraria”
  • $1, 814,340 for meals
  • $730,824 for travel
  • $290,395 for consulting fees
  • $79,660 for education

The study examined two databases, one covering Medicare Part D prescriptions, and the other, called Open Payments, covering “transfers of value” to physicians.

In 2015, 369,139 physicians that met the study’s criteria prescribed opioids under Medicare Part D. A year earlier, in 2014, 25,767 of them, or 7 percent, received 105,368 “non-research, opioid-related” payments totaling $9,071,976. Only 436 of these physicians, or 1.7 percent, received $1,000 or more in total.

“We identified all non-research payments involving opioid products, excluding buprenorphine hydrochloride marketed for addiction treatment,” the study says. “Total opioid claims for Medicare beneficiaries decreased from 60,055,242 in 2014 to 59,822,155 in 2015. Whereas physicians receiving no opioid-related payments had fewer opioid claims in 2015 than in 2014, physicians receiving such payments had more opioid claims.”

The Main Culprits

The three companies with the highest payments to doctors were Insys Therapeutics for $4,538,286; Teva Pharmaceuticals USA for $869,155; and Janssen Pharmaceuticals for $854,251.

Insys has been embroiled in serious federal investigations, and suits from at least 10 states, involving its marketing practices for Subsys, the company’s powerful fentanyl sublingual spray. Last December, five former Insys executives, including former CEO Michael Babich, were indicted on federal charges of conspiring to bribe doctors to prescribe their patients Subsys. Teva and Janssen, like almost every other pharma company, have also faced numerous legal problems, from wrangling over patents to charges of bribery.

If you or someone you care for has a problem with opioids or any other substance, don’t wait to call Novus Medical Detox Center at (855) 464-8550. We’re always here to help.

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