Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2022 Feb;97(2):250-260. doi: 10.1016/j.mayocp.2021.08.026.
To evaluate the association between pharmaceutical industry payments to rheumatologists and their prescribing behaviors.
A cross-sectional analysis was conducted of Medicare Part B Public Use File, Medicare Part D Public Use File, and Open Payments data for 2013 to 2015. Prescription drugs responsible for 80% of the total Medicare pharmaceutical expenditures in rheumatology were analyzed. We calculated the mean annual drug cost per beneficiary per year, the percentage of rheumatologists who received payments, and the median annual payment per physician per drug per year. Industry payments were categorized as food/beverage and consulting/compensation. Multivariable regression models were used to assess associations between industry payments and both prescribing patterns and prescription drug expenditures.
Of 4822 rheumatologists in the Medicare prescribing databases, 3729 received any payment from a pharmaceutical company during this time frame. Food/beverage payments were associated with an increased proportion of prescriptions for the related drugs (range, 1.5% to 4.5%) and an increased proportion of annual Medicare spending for the related drugs (range, 3% to 23%). For every $100 in food/beverage payments, the probability of prescribing increased (range, 1.5% to 14% for most drugs) and Medicare reimbursements increased (range, 6% to 44% for most drugs). Consulting/compensation payments were associated with an increased proportion of prescriptions (range, 1.2% to 1.6%) and an increased proportion of annual Medicare spending (range, 1% to 2%). For every $1000 in consulting/compensation payments, both the probability of prescribing increased (5% or less for most drugs) and Medicare reimbursements increased (less than 10% for most drugs).
Payments to rheumatologists by pharmaceutical companies are associated with increased probability of prescribing and Medicare spending.
评估制药业向风湿病学家支付款项与其处方行为之间的关联。
对 2013 年至 2015 年医疗保险 B 部分公共使用文件、医疗保险 D 部分公共使用文件和公开支付数据进行了横断面分析。分析了在风湿病学中占医疗保险药品总支出 80%的处方药。我们计算了每位受益人的平均年药物费用、收到付款的风湿病学家的百分比以及每位医生每种药物的年平均付款。行业付款分为食品/饮料和咨询/补偿。使用多变量回归模型评估行业支付与处方模式和处方药支出之间的关联。
在医疗保险处方数据库中的 4822 名风湿病学家中，有 3729 名在这段时间内从制药公司收到任何款项。食品/饮料付款与相关药物的处方比例增加（范围为 1.5%至 4.5%）以及相关药物的年度医疗保险支出比例增加（范围为 3%至 23%）有关。对于每 100 美元的食品/饮料付款，开处方的可能性增加（大多数药物的范围为 1.5%至 14%），医疗保险报销增加（大多数药物的范围为 6%至 44%）。咨询/补偿付款与处方比例增加（范围为 1.2%至 1.6%）和年度医疗保险支出比例增加（范围为 1%至 2%）有关。对于每 1000 美元的咨询/补偿付款，开处方的可能性增加（大多数药物为 5%或更少），医疗保险报销增加（大多数药物不到 10%）。
制药公司向风湿病学家支付款项与开处方的可能性增加和医疗保险支出增加有关。
