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

PloS one, 2016-05, Vol.11 (5), p.e0155474-e0155474 [Peer Reviewed Journal]

COPYRIGHT 2016 Public Library of Science ;COPYRIGHT 2016 Public Library of Science ;2016 Perlis, Perlis. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2016 Perlis, Perlis 2016 Perlis, Perlis ;ISSN: 1932-6203 ;EISSN: 1932-6203 ;DOI: 10.1371/journal.pone.0155474 ;PMID: 27183221

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Title:
Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs
Author: Perlis, Roy H ; Perlis, Clifford S
Lexchin, Joel
Subjects: Analysis ; Costs ; Costs and Cost Analysis ; Datasets ; Dermatology ; Drug Costs ; Drug Industry ; Drug Prescriptions ; Drugs ; Female ; Government programs ; Health aspects ; Health care ; Health care costs ; Humans ; Male ; Medical care, Cost of ; Medical devices ; Medical electronics ; Medical equipment ; Medical personnel ; Medical research ; Medicare Part D ; Medicine ; Medicine and Health Sciences ; Neurology ; Payments ; People and Places ; Physicians ; Physicians - economics ; Postal codes ; Practice ; Prescription drug plans ; Prescriptions ; Regression analysis ; Regression models ; Social Sciences ; Surgery ; Systematic review ; United States
Is Part Of: PloS one, 2016-05, Vol.11 (5), p.e0155474-e0155474
Description: 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. 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. 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. 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.
Publisher: United States: Public Library of Science
Language: English
Identifier: ISSN: 1932-6203
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0155474
PMID: 27183221
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
Public Library of Science (PLoS)
ProQuest Central
DOAJ Directory of Open Access Journals

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

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