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Doctors Who Get Gifts From Opioid Sales Reps Prescribe More Opioids, a Study Finds

In wooing a doctor, even a single meal makes a difference.

Doctors who received gifts from opioid painkillers manufacturers' sales representatives tend to prescribe more of those drugs than their peers who don't, a new study finds.

Researchers looked at a government database about doctors who wrote opioid prescriptions in 2015 that were covered under Medicare. The vast majority of those physicians didn't get any gifts at all from pharmaceutical reps. But those 7 percent of physicians who did receive gifts—which ranged from $11 meals to speaking fees of thousands of dollars—prescribed 9 percent more opioids than their peers who didn't take gifts. (Single meals were associated with a 0.7 percent increase in prescribing.)

Opioid prescriptions have declined in the last few years, as Americans have become more aware of dangers of addiction. But unnecessary prescriptions still seem to be a problem: In 2015, American doctors prescribed opioids at three times the rate they did in 1999, with rates varying as much as 600 percent between counties, the Centers for Disease Control and Prevention found. The CDC report didn't check whether medical need might explain the higher prescription rates in some counties, but the vast differences between places suggest at least some of those prescriptions are excessive.

The new study, conducted by a team of doctors and epidemiologists from medical centers in Massachusetts, California, and Rhode Island, suggests gifts could be one reason for excess prescribing. At the end of a short letter the team published in the journal JAMA Internal Medicine, they suggest opioid-makers voluntarily decrease or stop their marketing to doctors. These companies are now embroiled in hundreds of lawsuits in which cities, states, and tribes are accusing them of marketing unfairly to physicians, leading to overprescribing and addiction. The companies have denied these claims.

The new study's findings also fit in with a larger body of research that's found that doctors who take gifts from drug- and device-makers prescribe more brand-name drugs altogether. Even one meal can make a difference, perhaps subconsciously. None of these studies have been designed to show that gifts cause doctors to prescribe a drug rep's products more often, but they show a strong and consistent pattern of association. That's prompted some doctor's offices and hospitals to ban pharmaceutical sales visits, but, as of 2016, physician-researchers told Pacific Standard that such visits remained the primary means for doctors to learn about new drugs.