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Results of a recent study conducted by the University of Pittsburgh Graduate School of Public Health found that, when a pharmaceutical company offers gifts and other perks to a doctor, he or she has a higher incidence of prescribing opioids. Published in the Journal of General Internal Medicine, it’s the first in-depth research that identifies the symbiotic role pharmaceutical companies and medical practitioners have had in fueling the opioid crisis.

Background

doctor pouring pills into handResearchers examined prescribing Medicare Part D data from 2015 and 2016 and payments doctors received from pharmaceutical companies in 2014 and 2015. These amounts covered everything from promotional speaking and consulting gigs to lunches, promotional items, education and travel costs. The pharmaceutical companies all manufactured or promoted opioid prescriptions from 2014 through 2016. Researchers also looked for a relationship between the dollar value received and the amount of opioids prescribed by each doctor.

Researchers further collected data across medical specialties, covering primary care, surgery, psychiatry and neurology, rehabilitative and sports medicine, hematology and oncology, pain medicine and anesthesiology and other non-surgical specialties:

  • For the psychiatry and neurology specialty, doctors who received at least $100 from a pharmaceutical company were seven to 13 times as likely to prescribe opioids than those who received no gifts.
  • Comparing similar groups across primary care, doctors were 3.5 times as likely to prescribe opioids.
  • For hematology and other specialties, gifts made a slight difference in what doctors might prescribe patients.

Of the drug manufacturers examined, two companies in particular paid large sums to doctors. Close to 50 percent came from Insys, which manufactures and sells Subsys, a brand-name version of fentanyl. Nearly a quarter came from Purdue Pharmaceuticals, known for OxyContin, and now fighting litigation that’s leading to bankruptcy.

In 2017, doctors prescribed an opioid to 58 out of every 100 Americans, which doesn’t factor in heroin and illegal fentanyl usage.

Supporting Studies

The University of Pittsburgh study is not the first to establish this relationship. The Harvard T.H. Chan School of Public Health, Harvard Medical School (HMS) and CNN came across similar results. Particularly, opioid manufacturers allot large sums of money toward promoting their medications and the more a doctor recommends their products, the more the manufacturer offers in return. Examining the 2014 to 2015 period, researchers found that thousands of doctors nationally would receive $25,000 or more, and data indicated a correlation between the number of prescriptions a doctor wrote and how much a pharmaceutical company paid.

A study published in JAMA earlier in 2019 examined similar data at a geographical level. Here, data shows that counties with a higher number of doctors receiving kickbacks have above average overdose deaths.

Looking at this crisis from a different angle, another JAMA study this year found that doctors are more likely to prescribe opioids later in the day and when they’re behind. Covering 5,603 physicians and 678,319 patients with backaches, headaches, muscle and joint pain at health care clinics in 2017, the data found that doctors were one-third as likely to recommend opioids if the appointment was scheduled later in the day. If the doctor was behind schedule, he or she prescribed opioids in nearly 20 percent more instances.

Despite these results, the American Medical Association found that opioid prescriptions declined for a fifth year in a row – including a 33-percent drop from 2013 to 2018. Added to this, prescription morphine has declined 43 percent since 2011. Even just from 2017 to 2018, Americans received 12.4 percent fewer opioid prescriptions.
 
This epidemic has taken a devastating toll on many Americans. Pharmaceutical companies are responsible for spreading false information about addiction and bribing doctors to spread opioids to patients who may have benefited from other treatment programs. At Trantolo & Trantolo, we believe the drug manufacturers should be held accountable.