Moderated Poster

Poster, Podium & Video Sessions

MP76-03: Small Effect of Pharmaceutical Industry Payments to Physicians on Medicare Prescription Habits: Using Abiraterone and Enzalutamide

Monday, May 15
9:30 AM - 11:30 AM
Location: BCEC: Room 156

Presentation Authors: Omar Ayyash*, Jathin Bandari, Robert Turner, Bruce Jacobs, Benjamin Davies, Pittsburgh, PA

Introduction: Abiraterone and enzalutamide are both oral chemotherapeutic agents used in metastatic prostate cancer that have been aggressively marketed to physicians since FDA approval in 2011 and 2012, respectively. We sought to investigate if there is an association between pharmaceutical industry payments to physicians and prescriptions for abiraterone and enzalutamide.

Methods: Using the Open Payments Database from 2014, we determined the number and total dollar amount of payments from industry to each urologist or oncologist who prescribed abiraterone and enzalutamide. These data were merged with the 2013 Medicare Part D Provider and Utilization Data to identify the total claim count ascribed to each physician as well as the total drug cost per prescribing physician. Drug costs (primary outcome) and claim counts (secondary outcome) were compared between prescribers who did and did not receive industry payment using Wilcoxon rank-sum tests. A Spearman Rank correlation was used to assess the relationship between industry payments and total drug costs/total claim counts for each drug.

Results: For abiraterone, we identified 4918 Open Payment recipients and 1197 prescribers, of whom 615 were both recipients and prescribers. The median payment amount to prescribers was $72 (IQR $26-$114). For enzalutamide, we identified 7820 Open Payment recipients and 412 prescribers, of whom 289 were both recipients and prescribers. The median payment amount to prescribers was 59$ (IQR $25-$148). There was no statistical association between industry payment amount and total drug costs among abiraterone prescribers (ρ = 0.07, p = 0.11) and there was a small association among enzalutamide prescribers (ρ = 0.33, p < 0.001) (Figure).


Conclusions: Industry payments to prescribers of abiraterone and enzalutamide were common but of low amount. There was a small association between total drug costs and industry payments for prescribers of enzalutamide, but not abiraterone. Continued public reporting of industry payments to physicians will allow for further investigation of this relationship.

Source Of Funding: none

Omar Ayyash, MD, MPH

University of Pittsburgh Medical Center

My name is Omar Ayyash, MD, MPH and I am currently a PGY2 Urology resident at UPMC. I graduated as a triple major from the University of Pittsburgh with a BS in molecular biology and neuroscience, and a BA in economics with honors. I attended medical school at the University of Pittsburgh while simultaneously earning my MPH at the graduate school of public health in biostatistics and epidemiology. My primary research interests currently include endourology and health services research in urologic oncology.

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