ArticleBMJ (Clinical research ed.)2016
Association between payments from manufacturers of pharmaceuticals to physicians and regional prescribing: cross sectional ecological study.
Article in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 2 of them syntheses that pooled it.
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Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review.Annals of internal medicine · 2021Pooled it
- Economic Evaluations of Interventions to Optimize Medication Use in Older Adults with Polypharmacy and Multimorbidity: A Systematic Review.Clinical interventions in aging · 2021Pooled it
- Industry promotion of oncology drugs with accelerated approval that failed confirmatory trials.Journal of the National Cancer Institute · 2026Article
- Pharmaceutical marketing and patient trust: How do doctor-targeted campaigns affect patients?PloS one · 2026Article
- Relationship between industry payments to physicians and prescription patterns for PCSK9is, ARNis and DOACs: A report from the NCDR PINNACLE registry.American heart journal · 2026Article
- Geographic and clinical patterns of left atrial appendage occlusion utilization across the United States.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Balancing patient choice and health system capacity: a system dynamics model of dialysis in Thailand.BMC medicine · 2025Article
- Industry payments to US neurologists related to multiple sclerosis drugs and prescribing (2015-2019): a retrospective cohort study.BMJ open · 2025Observational
- Article
- Assessing the impact of the Physician Payments Sunshine Act on pharmaceutical companies' payments to physicians.PloS one · 2024Article
- Can peer effects explain prescribing appropriateness? a social network analysis.BMC medical research methodology · 2023Article
- Association of Device Industry Payments, Physician Supply, and Regional Utilization of Orthopedic and Cardiac Procedures.Journal of general internal medicine · 2023Article
- Off-Label Use vs Off-Label Marketing of Drugs: Part 1: Off-Label Use-Patient Harms and Prescriber Responsibilities.JACC. Basic to translational science · 2023Article
- Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database.PloS one · 2023Article
- Trends in Industry Payments to Diabetologists and Endocrinologists in the United States During the COVID-19 Pandemic.Cureus · 2022Article
- Industry influence in healthcare harms patients: myth or maxim?Breathe (Sheffield, England) · 2022Review
- Health Services and Policy Research in Canada: An Editor's Reflections.Healthcare policy = Politiques de sante · 2022Article
- Association Between Payments by Pharmaceutical Manufacturers and Prescribing Behavior in Rheumatology.Mayo Clinic proceedings · 2022Article
- Changes in industry marketing payments to physicians during the covid-19 pandemic: quasi experimental, difference-in-difference study.BMJ medicine · 2022Article
- Review
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo examine the association between payments made by the manufacturers of pharmaceuticals to physicians and prescribing by physicians within hospital referral regions.
designCross sectional analysis of 2013 and 2014 Open Payments and Medicare Part D prescribing data for two classes of commonly prescribed, commonly marketed drugs: oral anticoagulants and non-insulin diabetes drugs, overall and stratified by physician and payment type.
setting306 hospital referral regions, United States.
participants45 949 454 Medicare Part D prescriptions written by 623 886 physicians to 10 513 173 patients for two drug classes: oral anticoagulants and non-insulin diabetes drugs.
main outcome measuresProportion, or market share, of marketed oral anticoagulants and non-insulin diabetes drugs prescribed by physicians among all drugs in each class and within hospital referral regions.
resultsAmong 306 hospital referral regions, there were 977 407 payments to physicians totaling $61 026 140 (£46 174 600; €54 632 500) related to oral anticoagulants, and 1 787 884 payments totaling $108 417 616 related to non-insulin diabetes drugs. The median market share of the hospital referral regions was 21.6% for marketed oral anticoagulants and 12.6% for marketed non-insulin diabetes drugs. Among hospital referral regions, one additional payment (median value $13, interquartile range, $10-$18) was associated with 94 (95% confidence interval 76 to 112) additional days filled of marketed oral anticoagulants and 107 (89 to 125) additional days filled of marketed non-insulin diabetes drugs (P<0.001). Payments to specialists were associated with greater prescribing of marketed drugs than payments to non-specialists (212 v 100 additional days filled per payment of marketed oral anticoagulants, 331 v 114 for marketed non-insulin diabetes drugs, P<0.001). Payments for speaker and consulting fees for non-insulin diabetes drugs were associated with greater prescribing of marketed drugs than payments for food and beverages or educational materials (484 v 110, P<0.001). CONCLUSIONS AND STUDY LIMITATIONS: Payments by the manufacturers of pharmaceuticals to physicians were associated with greater regional prescribing of marketed drugs among Medicare Part D beneficiaries. Payments to specialists and payments for speaker and consulting fees were predominantly associated with greater regional prescribing of marketed drugs than payments to non-specialists or payments for food and beverages, gifts, or educational materials. As a cross sectional, ecological study, we cannot prove causation between payments to physicians and increased prescribing. Furthermore, our findings should be interpreted only at the regional level. Our study is limited to prescribing by physicians and the two drug classes studied.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.