Association between gifts from pharmaceutical companies to French general practitioners and their drug prescribing patterns in 2016: retrospective study using the French Transparency in Healthcare and National Health Data System databases
Association between gifts from pharmaceutical companies to French general practitioners and their drug prescribing patterns in 2016: retrospective study using the French Transparency in Healthcare and National Health Data System databases
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DOI：
10.1136/bmj.l6015
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发表时间：
2019-11-06
影响因子：
105.7
通讯作者：
Frouard, Pierre
中科院分区：
文献类型：
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作者：
Goupil, Bruno;Balusson, Frederic;Frouard, Pierre
评价制药公司向法国全科医生（GP）赠送的礼品与其药物处方模式之间的关联。使用两个法国数据库数据的回顾性研究（由法国国家健康保险系统管理的国家健康数据系统和医疗保健透明度）。参与者41 257名全科医生，2016年仅在私营部门工作，至少有5名登记患者。全科医生根据药品、医疗器械、主要结果测量主要结果测量是法国国家健康保险每次就诊的药物处方报销金额（到诊所或在家里）和11个药物处方效率指标，国民健康保险用来计算与医生绩效相关的财务激励。医生和病人的特点被用作调整变量。统计分析的显著性阈值为0.001。自2013年推出以来，2016年医疗保健透明数据库中没有报告礼物的GP组中，每次就诊的国家健康保险报销药物处方的金额较低（无礼物组）与2016年至少有一份礼物的全科医生组相比（-（原文如此）5.33（99.9%置信区间-（原文如此）6.99至-（原文如此）3.66）与2016年报告的礼品价值为（原文如此）1000或以上的GP组相比）（P=（原文如此）1000组），降压药（4.24%，与=（原文如此）1000组相比为3.72%至4.77%），以及他汀类药物（12.14%，11.03%至13.26%，与>=（原文如此）1000组相比），2013年至2016年期间至少有一份礼物的全科医生（P=（原文如此）1000组）比礼物价值为（原文如此）的全科医生2016年报告的240或更多，与所有ACE和沙坦处方相比，血管紧张素转换酶（ACE）抑制剂更多（1.67%，0.62%至2.71%），与2016年报告的礼品价值（原文如此）1000或更多的全科医生相比（P
OBJECTIVETo evaluate the association between gifts from pharmaceutical companies to French general practitioners (GPs) and their drug prescribing patterns.DESIGNRetrospective study using data from two French databases (National Health Data System, managed by the French National Health Insurance system, and Transparency in Healthcare).SETTINGPrimary care, France.PARTICIPANTS41 257 GPs who in 2016 worked exclusively in the private sector and had at least five registered patients. The GPs were divided into six groups according to the monetary value of the received gifts reported by pharmaceutical, medical device, and other health related companies in the Transparency in Healthcare database.MAIN OUTCOME MEASURESThe main outcome measures were the amount reimbursed by the French National Health Insurance for drug prescriptions per visit (to the practice or at home) and 11 drug prescription efficiency indicators used by the National Health Insurance to calculate the performance related financial incentives of the doctors. Doctor and patient characteristics were used as adjustment variables. The significance threshold was 0.001 for statistical analyses.RESULTSThe amount reimbursed by the National Health Insurance for drug prescriptions per visit was lower in the GP group with no gifts reported in the Transparency in Healthcare database in 2016 and since its launch in 2013 (no gift group) compared with the GP groups with at least one gift in 2016 (-(sic)5.33 (99.9% confidence interval -(sic)6.99 to -(sic)3.66) compared with the GP group with gifts valued at (sic)1000 or more reported in 2016) (P=(sic)1000 group), antihypertensives (4.24%, 3.72% to 4.77% compared with the =(sic)1000 group), and statins (12.14%, 11.03% to 13.26% compared with the >=(sic)1000 group) than GPs with at least one gift between 2013 and 2016 (P=(sic)1000 group) than GPs with gifts valued at (sic)240 or more reported in 2016, and more angiotensin converting enzyme (ACE) inhibitors compared with all ACE and sartan prescriptions (1.67%, 0.62% to 2.71%) compared with GPs with gifts valued at (sic)1000 or more reported in 2016 (P