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Drug Company Payments Over Time May Influence Rx Practices

WEDNESDAY, Feb. 13, 2019 -- Physicians treating certain cancers who consistently receive payments from a cancer drug's manufacturer are more likely to prescribe that drug instead of other treatments, according to a study published online Feb. 6 in The Oncologist.

Aaron P. Mitchell, M.D., from the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues evaluated whether practice setting at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, receipt of payments for purposes other than education or research (compensation payments), maximum annual dollar value received, and institutional conflict-of-interest policies were associated with the strength of the payment-prescribing association. Physician use of orally administered cancer drugs for four cancers (prostate, renal cell, lung, and chronic myeloid leukemia [CML]) were assessed in 2015, while payments were assessed from 2013 to 2015.

The researchers found that physicians who received payments for a drug in all three years had increased prescribing of that drug compared with those receiving payments for zero years for renal cell cancer (relative risk [RR] 1.81; 95 percent confidence interval [CI], 1.58 to 2.07), CML (RR, 1.22; 95 percent CI, 1.08 to 1.39), and lung cancer (RR, 1.69; 95 percent CI, 1.58 to 1.82) but not prostate cancer (RR, 0.97; 95 percent CI, 0.93 to 1.02). There was increased prescribing among physicians who received compensation payments or >$100 annually versus those who did not. However, NCI setting and institutional conflict-of-interest policies were not consistently associated with the direction of prescribing change.

"By combining records of industry gifts with prescribing records, this study identifies the consistency of payments over time, the dollar value of payments, and payments for compensation as factors that may strengthen the association between receiving payments and increased prescribing of that company's drug," the authors write.

One author disclosed financial ties to GlaxoSmithKline.

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Posted: February 2019

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