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 one in five 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 dollars involved in those payments.
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.
Scott Hadland is a pediatrician at Boston Medical Center and a specialist in helping adolescents and young adults struggling with addiction to opioids that, in most cases, they got as prescription painkillers from their doctors. He’s also one of the authors of the study, which was done by examining drug companies’ reporting of payments they 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, $87 was spent by opioid makers for every 1,000 residents. While that’s well below the top state of Colorado, it’s a huge deal because Ohio is near the top nationwide in terms of deaths related to opioids. Many people got started on their opioid addictions through prescription painkillers, and some turned to heroin, which can be mixed with other more deadly drugs.
Hadland is careful to note that prescription painkillers have a legitimate use, and there needs to be more work to understand how those payments might affect the behavior of the doctors who receive them. But some of what he found suggests there may be a connection. “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.
And Hadland says if a connection is proven, then there’s more work to do. “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 payments involving other kinds of medication also happen, but these payments come as Ohio’s opioid overdose deaths continue to soar, and the crisis is pushing the state to put limits on those painkiller prescriptions.