Nonresearch Physician Compensation Linked to Opioid Prescription Rates

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This study included physicians who had 10 or more opioid claims under Medicare Part D in 2015.
This study included physicians who had 10 or more opioid claims under Medicare Part D in 2015.

Nonresearch compensation given to physicians for prescribing opioids under Medicare Part D in 2014 may be associated with increased opioid prescriptions in 2015, according to a research letter published in JAMA Internal Medicine.

Scott E. Hadland, MD, MPH, MS, of the Grayken Center for Addiction at Boston Medical Center, and associates conducted an analysis to determine the impact that opioid products marketed by the pharmaceutical industry may have on physician prescribing rates.

The investigators used the Open Payments database and Medicare Part D Opioid Prescriber Summary File to tabulate payments by pharmaceutical companies to physicians in 2014 and the initial or refill opioid prescriptions written to Medicare beneficiaries in 2015, respectively.

In the study, payment was defined as “transfers of value from pharmaceutical companies.” Physicians who had 10 or more opioid claims under Medicare Part D in 2015 were included in the analysis (N= 369,139).

Of the cohort, 7.0% (n= 25,767) were provided 105,368 nonresearch, opioid-linked payments valued at $9,071,976; however, 1.7% (n= 436) received a sum of $1000 or more. The payments included speaking fees or honoraria, meals, travel, consulting fees, and education; meals had the most payments (n=97,020), while fees/honoraria had the most value ($6,156,757). The highest payment value by a single pharmaceutical company was $4,538,286.

“Amidst national efforts to curb the overprescribing of opioids, our findings suggest that manufacturers should consider a voluntary decrease or complete cessation of marketing to physicians,” noted the authors. “Federal and state governments should also consider legal limits on the number and amount of payments.”


Hadland SE, Cerdá M, Li Y, Krieger MS, Marshall BDL. Association of pharmaceutical industry marketing of opioid products to physicians with subsequent opioid prescribing. [Published online May 14, 2018] JAMA Intern Med. doi:10.1001/jamainternmed.2018.1999

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