Study Indicates Doctors Are Influenced by Big Pharma Dollars

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Unsurprisingly, research finds a strong correlation between Big Pharma physician compensation and increased rates of name-brand drug prescriptions

A report from ProPublica indicates that Big Pharma money is influencing the way doctors prescribe medication to patients.[i] Brand-name drugs like Linzess, a drug used to treat irritable bowel syndrome (IBS) and constipation, can cost patients around $1,500 annually.[ii]

Alternative generic brands like Miralax cost less than $200 annually, yet are prescribed much less frequently than their name-brand counterparts. So why are doctors prescribing costly brand name drugs like Linzess over the equally effective but far cheaper generic alternatives like Miralax?

According to the report's findings, the answer isn't that doctors are unaware of the efficacy of generic medicines, nor are they ignorant of the potential cost savings generic prescriptions could have for their patients. Instead, the report points to a far more insidious connection -- compensation from pharmaceutical companies.

Drug Company Money Influences Doctors' Prescribing Habits

Of the 50 brand-name drugs included in the report, the analysis found that doctors receiving compensation from drug companies prescribed name-brand drugs up to 141% more often than doctors who did not receive compensation.

For the IBS drug Linzess, doctors receiving payments wrote an average of 45% more prescriptions than non-compensated doctors, and researchers found that this correlation held for 46 of the 50 drugs studied.[iii]

In 2016, ProPublica published a report that showed similar findings.[iv] The report indicated that regardless of how much compensation was received, doctors who were paid by pharmaceutical companies tended to prescribe more brand-name medications than did other doctors not receiving compensation, and as compensation increased, so did the number of brand-name prescriptions.

According to the study, doctors who received more than $5,000 annually from pharmaceutical companies tended to prescribe as much as 10% more of those drugs than doctors who received no compensation.[v]

It's hard to believe that doctors could be unaware of the impact accepting payments from pharmaceutical companies are having on their patient interactions, but doctors like Huey Nguyen aren't so sure.

A gastroenterologist in Indiana, Nguyen's prescription rate of Linzess increased by almost twice as much after becoming a promotional speaker for the Linzess drug, but he claims his increased prescription rate is a result of his additional knowledge of the drug and its effects. He admits, however, that it's possible that Big Pharma speaking engagements, conferences and promotional engagement could "unconsciously" affect his prescription rates and those of other doctors.[vi]

Regardless of whether or not the choice is "conscious," the correlation remains clear -- Big Pharma dollars do impact doctors' medication choices, and for most Americans, these results aren't that surprising.

In 2019, Gallup published a poll showing that Americans distrust the pharmaceutical industry more than any other industry in the nation -- less, even, than the federal government.[vii] Criticisms range from the high cost of pharmaceutical drugs to the U.S. opioid crisis and Americans seem eager to disentangle themselves from the grip of the pharmaceutical industry.

The Efficacy of Generic Brand Medicine

As distrust of Big Pharma grows, the decades-old debate regarding the safety and efficacy of generic drugs compared to name-brand varieties tips in favor of generic medicines. Generic drugs, required to pass U.S. Food and Drug Administration (FDA) standards, work just as well as their name-brand counterparts, but can cost as much as 20% to 90% less.[viii],[ix] However, many patients often perceive generic medicines as being less effective or safe and end up paying substantially more because of their doubts.[x]

There is little question as to the safety and efficacy of generic medicines. Additional research has concluded that the clinical outcomes of generic drug use were comparable to name-brand varieties, and one 2019 study found that there is sometimes an improvement in outcome with generic drug use compared to brand name medicines.[xi] Researchers believe that increased health literacy and education around the efficacy and safety of generic medicines is the best way to sway public opinion and increase trust in generic alternatives.[xii],[xiii]

As the literature on generic brand medication grows, a shift away from name-brand drugs could potentially save patients thousands of dollars in health care costs. In the meantime, if you have questions about medications your doctor prescribes, ask.

Medication choices should be influenced by evidence of their effectiveness, not by marketing dollars, and it's important you feel comfortable speaking with your primary physician about any concerns you have.

Even if you don't want to raise questions about payments, you can always ask about alternative, potentially cheaper, varieties of the drug they are prescribing. For more information about Big Pharma's influence in the medical world, view some of our additional articles and abstracts on the subject:


References

[i] ProPublica December 20, 2019

[ii] Rx List, Side Effects of Linzess https://www.rxlist.com/linzess-side-effects-drug-center.htm

[iii] ProPublica December 20, 2019

[iv] ProPublica March 17, 2016

[v] ProPublica March 17, 2016

[vi] ProPublica December 20, 2019

[vii] Gallup September 3, 2019

[viii] BMC Pharmacol Toxicol. 2013; 14: 1.

[ix] ProPublica November 19, 2015

[x] BMC Med. 2015; 13: 173

[xi] PLoS Med. 2019 Mar; 16(3): e1002763.

[xii] BMC Med. 2015; 13: 173.

[xiii] Patient Educ Couns. Author manuscript; available in PMC 2009 Nov 1.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.

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Sayer Ji
Founder of GreenMedInfo.com

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