If your doctor is getting bribes from pharma companies, they’re much more likely to prescribe brand-name meds. This arrangement, which has been disputed by doctors forever, has finally been studied, thanks to new public data. And it proves what we knew all along—doctors in the pockets of drug suppliers return the favor by prescribing those companies’ drugs.
The Dollars for Doc study, carried out by the investigative journalism outfit ProPublica, couldn’t have happened before, because it uses data made public thanks to the Physician Payment Sunshine Act, a part of the 2010 Affordable Care Act. This law compels makers of drugs and medical devices to publicly report any payments they make to doctors. The first data became available in 2014, and covered the last five months of 2013. In that short time, $3.5 billion was paid out to doctors. Ever since, Dollar for Doctors has tracked these payments, and matched them up with data from Medicare, which tracks which drugs are prescribed to over 39 million people.
The results show, with startling clarity, that the two are connected.
Doctors who got money from drug and device makers—even just a meal—prescribed a higher percentage of brand-name drugs overall than doctors who didn’t, our analysis showed. Indeed, doctors who received industry payments were two to three times as likely to prescribe brand-name drugs at exceptionally high rates as others in their specialty.
"It again confirms the prevailing wisdom—that there is a relationship between payments and brand-name prescribing," said Dr. Aaron Kesselheim of Harvard Medical School.
According to the figures, "Nationwide, nearly nine in 10 cardiologists who wrote at least 1,000 prescriptions for Medicare patients received payments from a drug or device company in 2014, while seven in 10 internists and family practitioners did."
But Big Pharma disagrees. Holly Campbell, spokesperson for the Pharmaceutical Research and Manufacturers of America, told ProPublica that most physicians claim that a "great deal of their prescribing was influenced by their clinical knowledge and experience."
The numbers contradict this. Dr. Amer Syed of Jersey City, N.J. took more than $66,800 from drug companies in 2014. His brand-name prescribing rate "was more than twice the mean of his peers in internal medicine."
"I do prefer certain drugs over the others based on the quality of the medication and also the benefits that the patients are going to get," claims Syed.
However these doctors justify their acceptance of these bribes, and their subsequent bias towards their benefactors’ products, the fact is that prescribing brand-name drugs over generic is both pointless and costly. Costly to programs like Medicare, and costly to regular medical insurance companies, who pass that cost onto you, the customer. And generics are just as good as brand names, say studies, in both efficacy and safety—generics must meet the same FDA standards as any other drug.
The only case where brand-name drugs need to be supplied are in cases where there is no generic alternative, such as some cardiovascular treatments, or in HIV/AIDS treatment.
What will happen, now that we have clear evidence that doctors are influenced by these payoffs? Possibly nothing, at least not for a while. After all, the same pharma companies that are lining the pockets of the doctors’s white coats are also paying millions in lobbying dollars to make lawmakers look the other way.
In the meantime, you yourself can do something. Dollars for Docs has an online tool where you can look up your own doctor and see if they are getting drug money, and if so, how much. Check it, and next time you visit your doctor, ask them about it. Perhaps pressure for the bottom will be more effective than waiting for the government to regulate such a rich industry.