
Payments from Industry Associated with Greater Medicare Prescribing Costs (2016) - cassowary37
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155474
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cassowary37
thought I'd repost given recent interest on HN in conflict of interest -
rather than looking at impact of payments on specific medications, we wanted
to see how much payments distort prescribing costs overall. The variation in
impact across specialties was particularly notable (to me).

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refurb
I'm glad the article called out that they can't prove a casual connection
between payments and prescribing because the cause and effect could be the
reverse.

When drug companies are looking for physicians to speak at conferences or
speak to other physicians, they are looking for "true believers" in the
product. Why else would you work with them.

As such, it's not surprising these physicians prescribe more branded products
and that there is a higher cost per patient. I wonder whether or not that
would be true without the payments.

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cassowary37
Absolutely. Likely it's bidirectional - pharma identifies high prescribers (or
recognized experts) and invite them to speak at conferences or dinner
meetings. This increases their affinity for the product, and presumably their
prescribing. Lather, rinse, repeat. One /could/ sort out causation a bit more
by looking at lagged data (does prior-year payment influence subsequent year
prescribing, eg) - but it was such a colossal pain to match in the first place
that we never went back to look.

Of note: pharmacies sell docs' prescribing history to aggregators who sell it
to pharma, in fully identified form. So, pharma sales folk know exactly how
much of everything docs write.

