1 in 12 physicians received opioid-related compensation from pharmaceutical manufacturers
Because even small payments such as meals are associated with increased prescribing of marketed products, an examination of industry influences on prescribing amid an ongoing opioid crisis is warranted, the authors wrote.
About one in 12 U.S. physicians received a payment or other compensation from a manufacturer of an opioid during a 29-month period, a study found.
Researchers used data from the CMS Open Payments program database to identify opioid-related compensation from pharmaceutical manufacturers to physicians between August 2013, when mandated reporting began, and December 2015. Results were published online Aug. 8 and will appear in the September American Journal of Public Health.
During the study, 375,266 nonresearch opioid-related payments were made to 68,177 physicians, totaling $46,158,388. There were 829,962 active physicians in the United States at the beginning of the study period in 2013, so researchers calculated that payments went to about 8% of physicians, or one in 12.
Total payments increased from $18,958,125 in 2014 to $20,996,858 in 2015, an increase of 10.7%. The number of payments increased from 145,715 in 2014 to 184,237 in 2015, an increase of 26.4%. The five opioid products constituting the greatest proportion of payments were:
- fentanyl ($21,240,794; 46.0% of total dollars),
- hydrocodone ($7,123,421; 15.4% of total dollars),
- buprenorphine transdermal patch ($5,141,808; 11.1% of total dollars),
- oxycodone ($4,487,978; 9.7% of total dollars), and
- tapentadol ($4,296,130; 9.3% of total dollars).
Overall, payments related to FDA-approved abuse-deterrent formulations totaled $9,352,959 (20.3%), and payments for buprenorphine or buprenorphine/naloxone marketed for addiction treatment totaled $4,561,729 (9.9%). By comparison, payments related to NSAIDs amounted to $13,758,385. Most payments in dollars were for speaking fees or honoraria (63.2%), whereas food and beverages were the most frequent (93.9% of all payments).
Physicians received a median of one payment annually (interquartile range, [IQR], 1 to 2; maximum, 157). The median paid per physician annually was $15 (IQR, $7 to $42; maximum, $1,539,471). Payments were positively skewed, with the top 1% of physicians (n=681) receiving $2,639 or more annually. These physicians collectively received $38,073,796 (82.5% of total payments).
Anesthesiologists received the most in total annual payments (median, $50; IQR, $16 to $151; n=4,339), followed by physical medicine and rehabilitation (median, $48; IQR, $14 to $145; n=3,502) and pain medicine (median, $43; IQR, $12 to $125; n=3,090). Physicians specializing in family medicine received the largest total number of payments (n=20,592), at one in five family physicians.
These findings should prompt an examination of industry influences on opioid prescribing, since even small payments (including meals) are associated with increased prescribing of marketed products, the authors wrote.
“Financial transfers were substantial and widespread and may be increasing in number and value,” the authors wrote. “Although opioid prescribing declined nationally during the study period, these results should prompt an examination of industry influences on prescribing amid an ongoing opioid crisis.”