Study: Pharma payments do sway doctors' prescribing habits

With the Physician Payments Sunshine Act now in effect, more drugmakers are collecting doctors' names and dollar figures. But for some people, there's still that nagging question--why? After all, doctors say they aren't unduly influenced by their financial relationships with drugmakers. And most doctors don't rack up hundreds of thousands in pharma payments.

But a new study shows that--surprise!--payments do influence doctors' behavior. Yes, the average amount that flows from pharma to physician is about $1,700 per. Still, doctors are swayed by free dinners and speaking fees, the study finds, with prescriptions rising along with payments.

According to the study, published by the Social Science Research Network, doctors who accepted free meals, speaking fees, consulting payments and so on from one drugmaker were more likely to prescribe that drugmaker's brand-name products--not only compared with a competing brand in the same category, but with cheap generic versions, too. Even cheap generics of that very brand-name product.

Consider Pfizer's ($PFE) Lipitor and AstraZeneca's ($AZN) Crestor. Using data compiled by ProPublica on doctor payments and Medicare Part D prescriptions, the researchers compared physicians' use of both drugs. They found that Pfizer payments were associated with an increase in Lipitor scripts, with larger payments leading to bigger increases. Ditto with AstraZeneca payments and Crestor prescriptions. "Moreover, we find that payments from either company reduce the fraction of generic statin alternatives prescribed," the study authors wrote.

Interestingly enough, men proved more than twice as sensitive to pharma payments as women were, the analysis found. "This confirms experimental and field evidence suggesting that women are more honest and less corruptible than men," the researchers wrote. (For what it's worth, that evidence comes from studies of political corruption.)

And as NPR's Shots blog points out, the data shows that doctors practicing in states where corruption is more common--such as Louisiana--were more likely to be swayed by payments from drug companies, compared with doctors from less corruption-prone states, such as Oregon.

- read the NPR blog post
- get the paper from SSRN

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