Disclosure of industry payments to prescribers: industry payments might be a factor impacting generic drug prescribing.
Disclosure of industry payments to prescribers: industry payments might be a factor impacting generic drug prescribing.
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DOI：
10.1002/pds.4224
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发表时间：
2017-07
影响因子：
2.6
通讯作者：
Harris I
中科院分区：
文献类型：
--
作者：
Qian J;Hansen RA;Surry D;Howard J;Kiptanui Z;Harris I
2013年，制药公司向处方者支付了至少39.1亿美元，但表明行业支付是否使处方远离仿制药的证据有限。本研究考察了在医疗保险D部分处方者中，行业支付给处方者的金额与仿制药处方率之间的关系。在将2013年全国开放支付数据与2013年医疗保险提供者使用和支付数据联系起来后，对770,095名医疗保险D部分处方者进行了横断面分析。暴露变量被分类为行业支付给处方者的总金额（即膳食，旅行，研究，所有权）。结果是处方者的年度仿制药处方率。采用多变量广义线性回归模型检验行业支付金额与处方者年度仿制药处方率之间的关系，控制处方者的人口统计学和实践特征。在这个样本中，超过三分之一（38.0%）的医疗保险D部分处方者在2013年接受了行业支付。平均年度非专利药处方率在未获得行业支付的处方者中最高，在获得行业支付超过500美元的处方者中最低（分别为77.5%和71.3%,p<0.001）。收到行业付款与开处方者的仿制药开处方率独立相关；较高的支付与较低的仿制药处方率相对应。与年度仿制药处方率较高相关的其他开处方者特征包括男性、非东北地区、专业和患者数量。收到行业付款与降低仿制药处方率有关。这对病人护理和总医疗费用的影响值得进一步研究。
Pharmaceutical companies paid at least $3.91 billion to prescribers in 2013, yet evidence indicating whether industry payments shift prescribing away from generics is limited. This study examined the association between amount of industry payments to prescribers and generic drug prescribing rates among Medicare Part D prescribers. A cross-sectional analysis was conducted among 770,095 Medicare Part D prescribers after linking the 2013 national Open Payments data with 2013 Medicare Provider Utilization and Payment data. The exposure variable was categorized amount of total industry payments to prescribers (i.e., meals, travel, research, ownership). The outcome was prescriber’s annual generic drug prescribing rate. Multivariable generalized linear regression models were used to examine the association between amount of industry payments and prescriber’s annual generic drug prescribing rates, controlling for prescriber’s demographic and practice characteristics. In this sample, over one-third (38.0%) of Medicare Part D prescribers received industry payments in 2013. The mean annual generic drug prescribing rate was highest among prescribers receiving no payments and lowest among those receiving more than $500 of industry payments (77.5% vs. 71.3%, respectively; p<0.001). The receipt of industry payments was independently associated with prescribers’ generic drug prescribing rate; higher payments corresponded with lower generic drug prescribing rates. Other prescriber characteristics associated with higher annual generic drug prescribing rate included male sex, non-northeast region, specialty, and patient volume. Receipt of industry payments was associated with a decreased rate of generic drug prescribing. How this affects patient care and total medical costs warrants further study.
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影响因子：
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作者：
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通讯作者：
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