It’s not unusual for pharmaceutical companies to offer payments to doctors – for speaking fees, for travel expenses, for lunches and for gifts. But a new study shows 1 in 5 family doctors in America have received a payment involving an opioid medication – and Ohio is among the top states in the country in terms of money changing hands.
The study, in the current edition of the American Journal of Public Health, showed opioid drug makers paid over $46 million to more than 68,000 American doctors in a 28-month period ending in December 2015.
Ohio, which has been in a full-blown opioid crisis for several years, ranked eighth for total payments from opioid manufacturers to doctors.
One of the study’s coauthors, Scott Hadland, is a pediatrician at Boston Medical Center who works with adolescents and young adults struggling with opioid addiction. Hadland’s study began by examining drug companies’ reporting of payments made to doctors for marketed medications.
“What we found was pretty shocking – that 1 in 12 doctors in the United States have received a payment involving an opioid medication," Hadland said. "And when you look at family medicine doctors, who are on the front lines of primary care in this country, that number rose to 1 in 5.”
In Ohio, opioid makers spent $87 for every 1,000 residents. While that’s well below the top state of Colorado, it’s still a huge deal considering Ohio is at the top of states in terms of deaths related to opioids - eight Ohioans die every day from accidental overdoses.
Many people started their opioid addictions through prescription painkillers, and some turned to heroin, which can be mixed with other more deadly drugs. The crisis is pushing Ohio to put limits on those painkiller prescriptions.
In a speech to Columbus Police this month, U.S. Attorney General Jeff Sessions announced the Justice Department's new program targeting health care providers who abuse opioid prescriptions.
"If you are a doctor illegally prescribing opioids for profit, or a pharmacist letting these pills walk out the door onto the streets based on prescriptions you know are obtained under false pretenses, we're coming after you," Sessions said.
Hadland is careful to note that prescription painkillers have a legitimate use. And payments involving other kinds of medications happen as well.
But he says there does seem to be a correlation between the payments and the doctors’ approach to prescriptions.
“There are data, though, that show – including data using the same data set that we did – that show that when physicians receive payments for medications, they’re more likely to prescribe those brand-name medications, even when the payment is something very small, like a $14 or $15 meal," Hadland said.
More work is needed to better establish that connection, but Hadland says it would necessitate more action.
“If we do find that that link exists, then I think that we will have to as a group – as the medical profession, as a pharmaceutical industry, and as a group of policymakers in the United States – take a moment and ask ourselves, is this an appropriate practice and should we consider policy interventions like placing caps on these payments?” Hadland says.
