Drug Companies Providing Meals to Doctors: A Not-So-Tasty Policy
Why do pharmaceutical companies pay for doctors’ meals? The answer is simple – it is a not-so-subtle form of bribery designed to influence prescribing practices. If it didn’t work, it is hard to imagine why it would be done. A recent study in JAMA Internal Medicine supports a fairly intuitive notion. Doctors who are wined and dined – even when it costs less than $20 – are more likely to prescribe brand name, highly expensive medications.
The study found that doctors who received industry sponsored meals were significantly more likely to prescribe brand-name medications, compared to doctors who did not receive industry sponsored meals. Sure enough, doctors who were better fed, receiving either more or pricier meals, displayed an even higher likelihood of prescribing the advertised drug. The association held for four brand-name medications, including rosuvastatin, the third most expensive drug for Medicare Part D.
At HCFA, we are dedicated to advocating for high-quality healthcare at the lowest possible cost to the consumer, which is why we were steadfastly opposed the weakening of our gift ban law in 2012. The original law forbade pharmaceutical companies from providing doctors with free meals or other forms of payment, with the goal of preventing doctors from being tempted into prescribing more expensive drugs with no additional clinical benefit. The weakened law allows for "modest meals," but the regulations effectively put no limits on what can be provided. This new research demonstrates that even modest meals are pernicious. They are not only unnecessary, they are ethically dubious.
The first issue pertains to how doctors are getting their information. Pharmaceutical companies say that the free meals are a component of educational sessions. Should doctors be learning about medications from big-pharma over a pricey steak dinner? Or should they be relying on the latest peer-reviewed scientific studies, weighing the evidence of a multitude of more objective sources? Clearly, for patients to trust their doctors, the integrity of medical information dissemination must be preserved.
The second issue regards costs. Consider a Medicare patient who is prescribed an expensive brand-name drug when a cheaper, equally effective alternative is available. We, the taxpayers, pick up the tab for that drug. Therefore, in return for a small investment in the form of free meals, pharmaceutical companies receive a generous taxpayer subsidy. The same concept applies when insurers are forced to pay for more expensive drugs. That is, they pass on the costs to their members.
With costs of MassHealth rising steadily, it is crucial we find patient-centered ways to control costs. It is time for Massachusetts to reconsider the pharmaceutical gift policy.
- Mike DiBello