Qian Jingjing, Hansen Richard A, Surry Daniel, Howard Jennifer, Kiptanui Zippora, Harris Ilene
Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA.
IMPAQ International LLC, Columbia, MD, USA.
Pharmacoepidemiol Drug Saf. 2017 Jul;26(7):819-826. doi: 10.1002/pds.4224. Epub 2017 May 9.
Pharmaceutical companies paid at least $3.91bn to prescribers in 2013, yet evidence indicating whether industry payments shift prescribing away from generics is limited. This study examined the association between amount of industry payments to prescribers and generic drug prescribing rates among Medicare Part D prescribers.
A cross-sectional analysis was conducted among 770 095 Medicare Part D prescribers after linking the 2013 national Open Payments data with 2013 Medicare Provider Utilization and Payment data. The exposure variable was the categorized amount of total industry payments to prescribers (i.e., meals, travel, research, and ownership). The outcome was prescriber's annual generic drug prescribing rate. Multivariable generalized linear regression models were used to examine the association between the amount of industry payments and prescriber's annual generic drug prescribing rates, controlling for prescriber's demographic and practice characteristics.
In this sample, over one-third (38.0%) of Medicare Part D prescribers received industry payments in 2013. The mean annual generic drug prescribing rate was highest among prescribers receiving no payments and lowest among those receiving more than $500 of industry payments (77.5% vs. 71.3%, respectively; p < 0.001). The receipt of industry payments was independently associated with prescribers' generic drug prescribing rate; higher payments corresponded with lower generic drug prescribing rates. Other prescriber characteristics associated with higher annual generic drug prescribing rate included male sex, non-northeast region, specialty, and patient volume.
Receipt of industry payments was associated with a decreased rate of generic drug prescribing. How this affects patient care and total medical costs warrants further study. Copyright © 2017 John Wiley & Sons, Ltd.
2013年制药公司向开处方者支付了至少39.1亿美元,但关于行业支付是否会使处方从仿制药转向其他药物的证据有限。本研究调查了制药行业向开处方者支付的金额与医疗保险D部分开处方者的仿制药处方率之间的关联。
在将2013年全国公开支付数据与2013年医疗保险提供者利用和支付数据相链接后,对770095名医疗保险D部分开处方者进行了横断面分析。暴露变量是制药行业向开处方者支付的总金额类别(即餐饮、差旅、研究和股权)。结果是开处方者的年度仿制药处方率。使用多变量广义线性回归模型来研究行业支付金额与开处方者年度仿制药处方率之间的关联,并对开处方者的人口统计学和执业特征进行控制。
在这个样本中,超过三分之一(38.0%)的医疗保险D部分开处方者在2013年接受了行业支付。年度仿制药处方率在未接受支付的开处方者中最高,在接受超过500美元行业支付的开处方者中最低(分别为77.5%和71.3%;p<0.001)。接受行业支付与开处方者的仿制药处方率独立相关;支付金额越高,仿制药处方率越低。与较高年度仿制药处方率相关的其他开处方者特征包括男性、非东北地区、专业和患者数量。
接受行业支付与仿制药处方率降低有关。这如何影响患者护理和总医疗成本值得进一步研究。版权所有©2017约翰威立父子有限公司。