Murayama Anju
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
School of Medicine, Tohoku University, Sendai, Japan.
Heart. 2025 Jan 29;111(4):147-150. doi: 10.1136/heartjnl-2024-324453.
Although financial interactions between physicians and pharmaceutical and medical device companies could be potential conflicts of interest, in certain instances, industry promotion targeted at physicians may facilitate the early adoption of effective, novel care for patients such as sacubitril/valsartan in the USA. This study aims to evaluate associations between industry-sponsored meal payments to physicians and their prescribing patterns for sacubitril/valsartan in the USA.
Using the publicly accessible Centers for Medicare and Medicaid Services Medicare Part D database and the Open Payments Database, this study assessed associations between industry-sponsored meal payments to physician prescribers and total amounts of Medicare claims and spending for sacubitril/valsartan between 2015 and 2021.
Among 220 147 eligible physician prescribers, 60 568 (27.5%) received at least one meal payment related to sacubitril/valsartan from the manufacturer, totaling US$13.9 million. The receipt of meal payments was significantly associated with a higher proportion of sacubitril/valsartan prescriptions to all sacubitril/valsartan, angiotensin receptor blocker and angiotensin-converting enzyme inhibitor prescriptions, with an OR of 2.04 (95% CI: 1.98 to 2.10, p<0.001). Moreover, a 10% increase in the annual number of meal payments was associated with a 2.6% (95% CI: 2.5% to 2.6%, p<0.001) increase in the annual number of Medicare claims and a 7.3% (95% CI: 7.1% to 7.5%, p<0.001) increase in annual Medicare spending per physician.
Given the underprescription of sacubitril/valsartan in the USA, the positive associations between meal payments and physicians' prescribing patterns suggest that industry-sponsored meals may contribute to the early adoption of this cost-effective, novel heart failure drug among US Medicare beneficiaries.
尽管医生与制药和医疗器械公司之间的财务往来可能存在潜在利益冲突，但在某些情况下，针对医生的行业推广可能有助于在美国早期采用有效的新型患者护理方法，如沙库巴曲缬沙坦。本研究旨在评估美国行业赞助医生餐费支付与其沙库巴曲缬沙坦处方模式之间的关联。
本研究利用公开可得的医疗保险和医疗补助服务中心（CMS）医疗保险D部分数据库和公开支付数据库，评估2015年至2021年期间行业赞助医生餐费支付与沙库巴曲缬沙坦的医疗保险索赔总额和支出之间的关联。
在220147名符合条件的医生处方者中，60568名（27.5%）至少收到了制造商支付的一笔与沙库巴曲缬沙坦相关的餐费，总计1390万美元。餐费支付的接受与沙库巴曲缬沙坦处方在所有沙库巴曲缬沙坦、血管紧张素受体阻滞剂和血管紧张素转换酶抑制剂处方中所占比例较高显著相关，比值比为2.04（95%置信区间：1.98至2.10，p<0.001）。此外，年度餐费支付次数增加10%与医疗保险索赔年度次数增加2.6%（95%置信区间：2.5%至2.6%，p<0.001）以及每位医生的医疗保险年度支出增加7.3%（95%置信区间：7.1%至7.5%，p<0.001）相关。
鉴于沙库巴曲缬沙坦在美国的处方率较低，餐费支付与医生处方模式之间的正相关表明，行业赞助的餐食可能有助于在美国医疗保险受益人中早期采用这种具有成本效益的新型心力衰竭药物。
