One free meal can sway doctors who prescribe drugs

‘Doctors are human, and humans respond to gifts,’ a physician says.

‘Doctors are human, and humans respond to gifts,’ says a physician talking about prescribing drugs.

CHICAGO — As little as one free meal from a drug company can influence which medicines doctors prescribe for Medicare patients, according to a study using Medicare records and recently released data from the health care law’s Open Payments program.

The study highlights the subtle ways doctors may feel inclined to prescribe a drug after receiving just a small gift, even if the drug is more costly for patients and their insurance plans, the study authors said.

In a typical scenario, drug companies sometimes sponsor meals served during medical conferences and their sales reps may offer drug information and free samples to doctors waiting in line for food.

Dr. Adams Dudley, the study’s lead author, said that happened to him as a young physician – and it led him to prescribe brand-name drugs.

“Having just accepted even just a slice of pizza, you’re going to feel like, ‘Hey, I should let them talk to me,’” he said. “Doctors are human, and humans respond to gifts.”

The researchers calculated that an estimated $73 billion yearly could be saved if equivalent generics were prescribed instead of brand-name drugs, and patients pay for one-third of that excess cost.

“It’s not that it’s medically bad” for patients, Dudley said. “But it is definitely costing them more.”

The bottom line for patients? “Always ask if there’s a generic that’s just as good,” said Dudley, director of the Center for Healthcare Value at the University of California, San Francisco.

The Pharmaceutical Research and Manufacturers of America, an industry group, says it has a voluntary code that sets a $100 limit on “educational items” for doctors and says “modest occasional meals are permitted.”

Holly Campbell, a spokeswoman for the group, said the study “cherry-picks physician prescribing data for a subset of medicines to advance a false narrative” and doesn’t prove free meals influenced prescribing patterns.

The study involved prescribing information for nearly 280,000 doctors in Medicare’s prescription drug program. Researchers examined data on more than 63,000 drug company payments to these doctors from August through December 2013, made available under th health care law. Most payments were free meals worth less than about $20.



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