Meals, travel, lodging, education, consulting and speakers' fees: manufacturers of opioid medications often treat physicians to expensive gifts, a practice that's earned increased scrutiny in light of the opioid epidemic.
Now new research from the University of Pittsburgh finds doctors are more likely to prescribe opioid medications after receiving gifts from pharmaceutical companies, when compared to their peers who didn’t receive gifts.
"We all perceive ourselves to be immune to bias from gift giving, but even small gifts have been shown to create an unconscious bias,” said lead author Mara Hollander, a Ph.D. student specializing in health services research and policy at Pitt’s Graduate School of Public Health.
Hollander and her colleagues compared prescription rates of more than 236,000 doctors participating in Medicare Part D, from before and after they received a gift of $100 or more. An association between gifts and prescribing was found across specialties, but it was particularly pronounced among physicians in two particular fields.
Primary care doctors who received comped meals and other freebees were three-and-a-half times more likely to be in the top quartile of physicians in their specialty to prescribe opioids. Psychiatrists and neurologists were 13 times more likely to be in the top quartile of opioid prescribing, after receiving gifts.
“I don’t think we expected to see such a huge disparity between some of the specialties,” said Hollander. She said this might be due to several factors. “Specialties practice differently, their training is different, they have different patient populations.”
Hollander cautioned that these results are not proof of a gift’s influence, but they do establish an association between gifts and prescriptions. Now that this relationship has been confirmed, Hollander said the next step is to verify whether gifts are the catalyst for the increased prescribing, or if another factor is at play.
The study was published last week in the Journal of General Internal Medicine.
WESA receives funding from the University of Pittsburgh.