Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.

BACKGROUND:The U.S. Physician Payments Sunshine Act mandates the reporting of payments or items of value received by physicians from drug, medical device, and biological agent manufacturers. The impact of these payments on physician prescribing has not been examined at large scale. METHODS:We linked...

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Main Authors: Roy H Perlis, Clifford S Perlis
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4868346?pdf=render
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author Roy H Perlis
Clifford S Perlis
author_facet Roy H Perlis
Clifford S Perlis
author_sort Roy H Perlis
collection DOAJ
description BACKGROUND:The U.S. Physician Payments Sunshine Act mandates the reporting of payments or items of value received by physicians from drug, medical device, and biological agent manufacturers. The impact of these payments on physician prescribing has not been examined at large scale. METHODS:We linked public Medicare Part D prescribing data and Sunshine Act data for 2013. Physician payments were examined descriptively within specialties, and then for association with prescribing costs and patterns using regression models. Models were adjusted for potential physician-level confounding features, including sex, geographic region, and practice size. RESULTS:Among 725,169 individuals with Medicare prescribing data, 341,644 had documented payments in the OPP data (47.1%). Among all physicians receiving funds, mean payment was $1750 (SD $28336); median was $138 (IQR $48-$394). Across the 12 specialties examined, a dose-response relationship was observed in which greater payments were associated with greater prescribing costs per patient. In adjusted regression models, being in the top quintile of payment receipt was associated with incremental prescribing cost per patient ranging from $27 (general surgery) to $2931 (neurology). Similar associations were observed with proportion of branded prescriptions written. CONCLUSIONS:While distribution and amount of payments differed widely across medical specialties, for each of the 12 specialties examined the receipt of payments was associated with greater prescribing costs per patient, and greater proportion of branded medication prescribing. We cannot infer a causal relationship, but interventions aimed at those physicians receiving the most payments may present an opportunity to address prescribing costs in the US.
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spelling doaj.art-fcd978d9c0d44a06a277eabebdf847b92022-12-21T19:49:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01115e015547410.1371/journal.pone.0155474Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.Roy H PerlisClifford S PerlisBACKGROUND:The U.S. Physician Payments Sunshine Act mandates the reporting of payments or items of value received by physicians from drug, medical device, and biological agent manufacturers. The impact of these payments on physician prescribing has not been examined at large scale. METHODS:We linked public Medicare Part D prescribing data and Sunshine Act data for 2013. Physician payments were examined descriptively within specialties, and then for association with prescribing costs and patterns using regression models. Models were adjusted for potential physician-level confounding features, including sex, geographic region, and practice size. RESULTS:Among 725,169 individuals with Medicare prescribing data, 341,644 had documented payments in the OPP data (47.1%). Among all physicians receiving funds, mean payment was $1750 (SD $28336); median was $138 (IQR $48-$394). Across the 12 specialties examined, a dose-response relationship was observed in which greater payments were associated with greater prescribing costs per patient. In adjusted regression models, being in the top quintile of payment receipt was associated with incremental prescribing cost per patient ranging from $27 (general surgery) to $2931 (neurology). Similar associations were observed with proportion of branded prescriptions written. CONCLUSIONS:While distribution and amount of payments differed widely across medical specialties, for each of the 12 specialties examined the receipt of payments was associated with greater prescribing costs per patient, and greater proportion of branded medication prescribing. We cannot infer a causal relationship, but interventions aimed at those physicians receiving the most payments may present an opportunity to address prescribing costs in the US.http://europepmc.org/articles/PMC4868346?pdf=render
spellingShingle Roy H Perlis
Clifford S Perlis
Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.
PLoS ONE
title Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.
title_full Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.
title_fullStr Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.
title_full_unstemmed Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.
title_short Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs.
title_sort physician payments from industry are associated with greater medicare part d prescribing costs
url http://europepmc.org/articles/PMC4868346?pdf=render
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