Generic Medications Versus Branded Medications
A ProPublica analysis looks into whether physicians are more likely to prescribe brand name drugs if they receive payments from drug makers and pharmaceutical companies. Generic medications are introduced to the market after the patent on brand names has expired; they are much cheaper and usually work just as well. Brand names, ProPublica notes, are expensive and more heavily marketed.
The analysis found that industry payments were associated with prescribing brand names, and that the likelihood increased with increasing payment amounts. Even small compensations, such as a meal, had an impact. The analysis only shows that payments are associated with an increased likelihood of prescribing brand names. It does not show that these payments caused doctors to prescribe a certain way.
“You can debate if these payments are good or bad, or neither, but what isn’t debatable is that they permeate the profession.” said Dr. Walid Gellad, an associate professor of medicine at the University of Pittsburgh and co-director of its Center for Pharmaceutical Policy and Prescribing, who reviewed the analysis.
ProPublica matched industry payments to doctors’ treatment decisions in Medicare’s prescription drug program. Receiving an industry payment was associated with a two to three-fold increased likelihood of prescribing brand name drugs at very high rates compared to other physicians in the specialty.
Dr. Aaron Kesselheim, an associate professor of medicine at Harvard Medical School, said “It again confirms the prevailing wisdom … that there is a relationship between payments and brand-name prescribing,” Dr. Kesselheim provided guidance on the early versions of ProPublica’s analysis. “This feeds into the ongoing conversation about the propriety of these sorts of relationships. Hopefully we’re getting past the point where people will say, ‘Oh, there’s no evidence that these relationships change physicians’ prescribing practices.'”
There was also variation between states, the analysis found. Compared to Vermont, Minnesota, Wisconsin and Maine, the rate of industry payments in Nevada, Alabama, Kentucky and South Carolina was twice as high.