School of Medicine, Tohoku University, Sendai City, Miyagi, Japan.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
J Eval Clin Pract. 2024 Apr;30(3):435-439. doi: 10.1111/jep.13956. Epub 2023 Dec 27.
Healthcare industry sometimes make large marketing payments to physicians. Previous studies have demonstrated that there are significant associations between industry marketing practices and physicians' prescribing behaviours in several specialties. Given the current increasing introduction of many novel biologics for atopic dermatitis and increasing payments to dermatologists, the industry payments to dermatologists for atopic dermatitis drugs could be associated with their prescribing patterns in the United States.
This study aims to evaluate association between dermatologists' dupilumab prescription behaviours and manufacturer's sponsored meal payments to dermatologists in the United States.
Using the Centers for Medicare and Medicaid Services and the Open Payments Database, this cross-sectional analysis evaluated associations between manufacturer's sponsored meal payments to dermatologists related to dupilumab and dermatologists' dupilumab prescriptions between 2017 and 2021. Associations were evaluated using logistic generalised estimating equations (GEE) and negative binomial regression GEE models at individual dermatologist level.
Among 2852 dermatologists prescribing dupilumab, 74.5% received meal payments amounting to $1,083,919 between 2017 and 2021. Dermatologists receiving meal payments were more likely to prescribe dupilumab (odds ratio 1.50, 95% confidence interval [CI]: 1.37-1.65). There were also consistent dose-response associations between meal payments and total claims as well as Medicare spending. Dermatologists who received 1, 2-5, 6-10, and 11-15 meal payments per year reported 1.13 (95% CI: 1.03-1.24, p < 0.05), 1.35 (95% CI: 1.24-1.46, p < 0.001), 1.64 (95% CI: 1.48-1.82, p < 0.001), and 2.10 (95% CI: 1.78-2.47, p < 0.001) times more dupilumab-related claims in the year when they received the payments than those who did not receive the payments, respectively.
This study found that significant associations between industry-sponsored meal payments and increased dupilumab prescriptions, shedding light on the potential influence of financial relationships on clinical practice. The findings call for heightened awareness among dermatologists, patients, and policymakers regarding the impact of these relationships on healthcare expenditures and decision-making in the United States. Future research is warranted to further explore these associations longitudinally.
医疗行业有时会向医生支付大量营销费用。先前的研究表明，在多个专业领域，行业营销实践与医生的处方行为之间存在显著关联。鉴于目前有许多新型特应性皮炎生物制剂的引入以及向皮肤科医生支付的费用不断增加，因此，向皮肤科医生支付特应性皮炎药物的行业支付款项可能与他们在美国的处方模式有关。
本研究旨在评估美国皮肤科医生使用度普利尤单抗的情况与制药商向皮肤科医生提供的与度普利尤单抗相关的餐费之间的关联。
本横断面分析使用医疗保险和医疗补助服务中心和公开支付数据库，评估了 2017 年至 2021 年间与度普利尤单抗相关的制药商向皮肤科医生提供的餐费与皮肤科医生开具度普利尤单抗处方之间的关联。在个体皮肤科医生层面，使用逻辑广义估计方程（GEE）和负二项回归 GEE 模型评估关联。
在开具度普利尤单抗的 2852 名皮肤科医生中，有 74.5%在 2017 年至 2021 年间收到了金额为 1083919 美元的餐费。接受餐费的皮肤科医生更有可能开具度普利尤单抗（优势比 1.50，95%置信区间 [CI]：1.37-1.65）。在餐费和总报销额以及医疗保险支出之间也存在一致的剂量反应关联。每年接受 1、2-5、6-10 和 11-15 次餐费的皮肤科医生报告称，在接受支付的那一年，与度普利尤单抗相关的报销额分别增加了 1.13（95% CI：1.03-1.24，p<0.05）、1.35（95% CI：1.24-1.46，p<0.001）、1.64（95% CI：1.48-1.82，p<0.001）和 2.10（95% CI：1.78-2.47，p<0.001）倍。
本研究发现，行业赞助的餐费与度普利尤单抗处方的增加之间存在显著关联，这揭示了财务关系对临床实践的潜在影响。这些发现呼吁美国的皮肤科医生、患者和政策制定者提高对这些关系对医疗保健支出和决策影响的认识。有必要进行进一步的研究来纵向探讨这些关联。
