Journal
MAYO CLINIC PROCEEDINGS
Volume 97, Issue 2, Pages 250-260Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.mayocp.2021.08.026
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Funding
- Centers for Disease Control and Prevention [U01 U01DP006491]
- Rheumatology Research Foundation Scientist Development Award
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Women's Health Career Enhancement Award
- Eaton Family Career Development Award
- National Institute of Diabetes and Digestive and Kidney Diseases [K23DK114497, R03DK114497, P30DK111024]
- AARP Quality Measure Innovation Grant
- Mayo Clinic
- Centers for Medicare and Medicaid Services
- Yale University from Johnson and Johnson
- Medical Device Innovation Consortium as part of the National Evaluation System for Health Technology (NEST)
- Food and Drug Administration for the YaleeMayo Clinic Center for Excellence in Regulatory Science and Innovation (CERSI) program [U01FD005938]
- Agency for Healthcare Research and Quality [R01HS022882, 1U19HS024075, R01HS025164, R01HS025402, R03HS025517]
- National Heart, Lung, and Blood Institute of the National Institutes of Health [R01HS025164, R01HL144644, R56HL130496, R01HL131535]
- Laura and John Arnold Foundation
- Mayo Clinic from the Food and Drug Administration [U01FD005938]
- Centers of Medicare and Medicaid Innovation under the Transforming Clinical Practice Initiative (TCPI)
- National Science Foundation
- Patient-Centered Outcomes Research Institute (PCORI)
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Payments from pharmaceutical companies to rheumatologists are associated with increased probability of prescribing and Medicare spending.
Objective: To evaluate the association between pharmaceutical industry payments to rheumatologists and their prescribing behaviors. Methods: A cross-sectional analysis was conducted of Medicare Part B Public Use File, Medicare Part D Public Use File, and Open Payments data for 2013 to 2015. Prescription drugs responsible for 80% of the total Medicare pharmaceutical expenditures in rheumatology were analyzed. We calculated the mean annual drug cost per beneficiary per year, the percentage of rheumatologists who received payments, and the median annual payment per physician per drug per year. Industry payments were categorized as food/beverage and consulting/compensation. Multivariable regression models were used to assess associations between industry payments and both prescribing patterns and prescription drug expenditures. Results: Of 4822 rheumatologists in the Medicare prescribing databases, 3729 received any payment from a pharmaceutical company during this time frame. Food/beverage payments were associated with an increased proportion of prescriptions for the related drugs (range, 1.5% to 4.5%) and an increased proportion of annual Medicare spending for the related drugs (range, 3% to 23%). For every $100 in food/beverage payments, the probability of prescribing increased (range, 1.5% to 14% for most drugs) and Medicare reimbursements increased (range, 6% to 44% for most drugs). Consulting/compensation payments were associated with an increased proportion of prescriptions (range, 1.2% to 1.6%) and an increased proportion of annual Medicare spending (range, 1% to 2%). For every $1000 in consulting/compensation payments, both the probability of prescribing increased (5% or less for most drugs) and Medicare reimbursements increased (less than 10% for most drugs). Conclusion: Payments to rheumatologists by pharmaceutical companies are associated with increased probability of prescribing and Medicare spending. (C) 2021 Mayo Foundation for Medical Education and Research.
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