The Relationship of Industry Payments to Prescribing Behavior: A Study of Degarelix and Denosumab.
The Relationship of Industry Payments to Prescribing Behavior: A Study of Degarelix and Denosumab.
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DOI：
10.1016/j.urpr.2016.03.007
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发表时间：
2017-01-01
期刊：
影响因子：
0.8
通讯作者：
Davies, Benjamin J
中科院分区：
文献类型：
--
作者：
Bandari, Jathin;Turner, Robert M 2nd;Davies, Benjamin J
导读：金融关系对制药公司的影响仍然存在争议。我们的目的是评估药物支付与degarelix和denosumab处方模式之间的潜在关系。材料和方法：医疗保险提供者使用和支付数据：医生和其他供应商公共使用文件（Medicare B）数据包含2012年索赔与2013年下半年OpenPayments （Sunshine Act）数据的比较。在两个数据库中交叉引用了为degarelix或denosumab开具医疗保险账单的泌尿科医生和肿瘤医生，并将付款汇总到一个统一的数据集中。根据收到的阳光付款比较调整后的受益人人数和医疗保险报销总额，并评估阳光付款金额与医疗保险报销总额之间的关系。结果：160名处方degarelix和1507名处方denosumab的患者中，分别有91名（57%）和854名（57%）获得了Sunshine付款。接受Sunshine付款的Degarelix处方者的医疗保险总报销中位数较高（13,257美元对9,554美元，p = 0.01）。接受Sunshine付款的Denosumab处方者调整受益人数中位数较高（55比50，p < 0.001），总医疗保险报销中位数较高（69,620美元对60,732美元，p < 0.001）。在多变量分析中，接受Sunshine付款（调整后的中位数差值为5,844美元，95% CI为937 - 10,749美元）和肿瘤专科（调整后的中位数差值为34,380美元，95% CI为26,715 - 42,045美元）与denosumab的医疗保险报销总额独立相关。结论：在degarelix和denosumab的案例中，制药公司的支付与处方者的处方行为模式之间存在弱关联。
INTRODUCTION: The influence of financial ties to pharmaceutical companies remains controversial. We aimed to assess a potential relationship between pharmaceutical payments and prescription patterns for degarelix and denosumab.MATERIALS AND METHODS: Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (Medicare B) data containing 2012 claims compared to OpenPayments (Sunshine Act) data for the second half of 2013. Urologists and medical oncologists who billed Medicare for degarelix or denosumab were cross referenced in both databases and payments were aggregated into a consolidated dataset. Adjusted beneficiary count and total Medicare reimbursement were compared according to receipt of Sunshine payment, and an association between Sunshine payment amount and total Medicare reimbursement was also assessed.RESULTS: Of the 160 prescribers of degarelix and 1,507 prescribers of denosumab, 91 (57%) and 854 (57%) received Sunshine payment, respectively. Degarelix prescribers who received Sunshine payment had higher median total Medicare reimbursement ($13,257 vs. $9,554, p = 0.01). Denosumab prescribers who received Sunshine payment had both higher median adjusted beneficiary count (55 vs. 50, p < 0.001) and median total Medicare reimbursement ($69,620 vs. $60,732, p < 0.001). On multivariable analysis, both receipt of Sunshine payment (adjusted median difference $5,844, 95% CI $937 - $10,749) and oncology specialty (adjusted median difference $34,380, 95% CI $26,715 - $42,045) were independently associated with total Medicare reimbursement for denosumab.CONCLUSIONS: In the case of degarelix and denosumab, there is a weak association between pharmaceutical company payments on prescribers' prescription behavior patterns.