Patient requests + free food = more branded scripts, survey finds

Doctors choose branded drugs when they don't have to. That's a fact. But which physicians are most likely to prescribe expensive meds--and who's best at influencing them to do so? Those are the questions posed by researchers from the Harvard Medical School and Massachusetts General Hospital, published in this week's JAMA Internal Medicine.

The answers? Patients and pharma companies are both adept at twisting physicians' arms toward branded drugs.

The researchers surveyed 3,500 doctors in 7 specialties, finding that about 40% of physicians sometimes or often prescribe a brand-name drug rather than a generic when a patient asks for the brand. That statistic suggests that drugmakers' multibillion-dollar investment in direct-to-consumer advertising pays off.

Meanwhile, doctors were also influenced by their relationships with drugmakers. "Physicians who received industry-provided food and/or beverages in the workplace and samples were significantly more likely to accede to patient demands for brand-name drugs," the JAMA letter stated. In fact, docs who simply meet with reps to gain information about drugs are more likely to give in to patients.

Some physicians were more susceptible to patient requests than others. Older doctors--those who'd been practicing at least 30 years--were more likely to give in than were those practicing for fewer than 10 years. Pediatricians, anesthesiologists, cardiologists and general surgeons were least likely to comply, compared with internists. And doctors in small practices let patients persuade them more often than physicians at hospitals or medical schools did.

- read a preview of the JAMA piece