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MP69-08: Pharmaceutical industry payments and physician prescribing of urologic drugs

Monday, May 15
7:00 AM - 9:00 AM
Location: BCEC: Room 153

Presentation Authors: Parth Modi*, New Brunswick, NJ, Matthew Ingham, Boston, MA, Eric Singer, New Brunswick, NJ, Steven Chang, Boston, MA

Introduction: The effects of industry payments to physicians on prescribing habits are not well understood. We aimed to determine the association between the receipt of industry payments and the prescribing of alpha-blockers and overactive bladder (OAB) medications.

Methods: The Open Payments Program (OPP) database and Medicare Part D claims database for 2014 were linked. This provided industry payment information and prescription information for individual physicians in the US. We identified all physicians who prescribed any alpha-blocker or OAB drug. We also identified actively promoted drug (based on payments) within each group. Silodosin was the only actively promoted alpha-blocker. Fesoterodine, solifenacin, and mirabegron were the actively promoted OAB drugs. For each promoted drug, we calculated the proportion of physicians who &[Prime]preferred&[Prime] the promoted drug, i.e. prescribed the promoted drug more often than all other drugs in that class combined. Regression analysis was performed to quantify the effect of industry payment on &[Prime]preferred&[Prime] prescribing. Analysis was conducted for any payment, greater than the median payment, and high payment (>$100). Prescribing physicians were categorized as urologists or non-urologists.

Results: In 2014, among the 108,680 physicians who prescribed an alpha blocker or an overactive bladder medication through Medicare Part D, 66,726 received at least one industry payment by the manufacturer of that drug. For each promoted drug, physicians who received any payment from its manufacturer prescribed that drug more often, relative to all drugs in its class. Receipt of payment from the promoting company was associated with significantly increased odds of preferentially prescribing that drug (Table 1). This effect was significant when considering all physicians and non-urologists. However, when considering urologists alone, no significant effect was noted. Sensitivity analyses conducted using median payment and high payment thresholds confirmed these findings.

Conclusions: Receipt of industry payment is associated with increased prescribing of promoted urologic drugs. This effect varies according to specialty, possibly reflecting the strength of established prescribing patterns or close familiarity with these drugs for urologists as compared to other physicians.

Source Of Funding: none

Parth K. Modi, MD

Rutgers Robert Wood Johnson Medical School

Parth K Modi MD is a chief urology resident at Rutgers RWJMS in New Brunswick, NJ. He will be starting his SUO-accredited fellowship in Urologic Oncology and Health Services Research at the University of Michigan in July 2017. He grew up in Titusville, Florida and completed his BA and MD degrees at Northwestern University.

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