Opioid manufacturer payments to physicians tied to more prescribing

Study in JAMA Internal Medicine: Industry pays $9 million

Opioid-related nonresearch payments made to physicians in 2014 were associated with greater opioid prescribing in 2015, according to a research letter published online in JAMA Internal Medicine May 14. All told, 7% of physicians who prescribed opioids under Medicare Part D received such payments, for a total of more than $9 million. Physicians who received such payments had 9.3% more opioid claims in 2015 compared with those who did not receive payments.

In the study, researchers obtained information from two databases, first to identify nonresearch payments involving opioids other than buprenorphine products marketed for addiction treatment, and second to analyze claims from physicians who wrote opioid prescriptions filled by Medicare beneficiaries. They found that 25,767 physicians who prescribed opioids for this population received nonresearch payments, with 436 of them receiving more than $1,000.

Types of payment included speaking fees or honoraria, meals, travel, consulting fees, and education. INSYS Therapeutics, makers of fentanyl sublingual spray (Subsys) made payments totaling more than $4.5 million, followed by Teva Pharmaceuticals USA, which paid $869,155, and Janssen, which paid $854,251.

Most of the physicians who received payments received them in the form of free meals, with a median payment value of $13. Each meal received in 2014 was associated with an increased number of opioid claims in 2015, and each additional meal was associated with an increase of 0.7% in opioid claims.

The researchers noted that their findings did not establish cause and effect and that physicians who receive payments may be predisposed to prescribe opioids.