Tuesday, May 15, 2018

Are pharmaceutical marketing payments to physicians for opioids associated with prescribing?

Are Pharmaceutical Marketing Payments to Physicians for Opioids Associated With Prescribing?

Bottom Line: Pharmaceutical industry marketing of opioid products to physicians through nonresearch payments, which can include speaking fees and meals, was associated with greater opioid prescribing.

Why The Research Is Interesting:
Many opioid-related overdose deaths involve prescription opioids, and prescription opioids can commonly be a person’s first encounter on a path to illicit use. Marketing by the pharmaceutical industry to physicians is widespread but marketing of opioids and its influence on prescribing is unclear.

What (Study Methods): Linking of two U.S databases to identify all nonresearch payments from the pharmaceutical industry to physicians marketing opioid products (excluding buprenorphine hydrochloride marketed for addiction treatment) and to gather information on all claims from physicians who wrote opioid prescriptions (initial or refill) filled for Medicare beneficiaries in 2015

Study Limitations: Possibility of reverse causation because physicians who receive industry payments may be inclined to prescribe opioids; study establishes association, not cause and effect
Amidst national efforts to curb the overprescribing of opioids, our findings suggest that manufacturers should consider a voluntary decrease or complete cessation of marketing to physicians. Federal and state governments should also consider legal limits on the number and amount of payments.

Research Letter
JAMA Intern Med. Published online May 14, 2018.
Association of Pharmaceutical Industry Marketing of Opioid Products to Physicians With Subsequent Opioid Prescribing
Scott E. Hadland, MD, MPH, MS1,2,3; Magdalena Cerdá, DrPH, MPH4; Yu Li, MD, PhD5; et al Maxwell S. Krieger, BS5; Brandon D. L. Marshall, PhD5

Despite the increasing contribution of heroin and illicitly manufactured fentanyl to opioid-related overdose deaths in the United States, 40% of deaths involve prescription opioids.1 Prescription opioids are commonly the first opioid encountered in a trajectory toward illicit consumption.2 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.3

Pharmaceutical industry marketing to physicians is widespread, but it is unclear whether marketing of opioids influences prescribing.4 We studied the extent to which pharmaceutical industry marketing of opioid products to physicians during 2014 was associated with opioid prescribing during 2015.
Continue reading: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2681059

Related Material: Two other studies, “Weekly and Monthly Subcutaneous Buprenorphine Depot Formulations vs. Daily Sublingual Buprenorphine with Naloxone for Treatment of Opioid Use Disorder: A Randomized Clinical Trial,” and “Association of an Opioid Standard of Practice Intervention with Intravenous Opioid Exposure in Hospitalized Patients,” also are available on the For The Media website.

For more details and to read the full study, please visit the For The Media website.
Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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