January 27, 2020
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Many stimulant prescribers are influenced by pharmaceutical marketing

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Rising rates of stimulant prescribing may be partly influenced by pharmaceutical industry marketing to physicians, according to study findings published in JAMA Pediatrics.

“Our study results indicate that the marketing of stimulants by pharmaceutical companies could be contributing to the increased prescribing of both generic and brand name medications for children with ADHD,” Scott Hadland, MD, MS, MPH, pediatrician and addiction specialist at the Grayken Center for Addiction at Boston Medical Center, said in a press release. “Given the potential for the misuse of these medications — and the fact that misuse often starts during adolescence and young adulthood — we need to more closely examine whether there should be standards in place limiting the marketing of stimulant medications directly to providers.”

According to Hadland and colleagues, prescription stimulant use doubled from 2006 to 2016 in the United States and resulted in more pharmaceutical expenditures for children than any other medication class in 2013. They noted that stimulants are often used nonmedically, which makes it important to determine factors that may contribute to their potential oversupply. Prior research has determined an association between pharmaceutical company marketing and increased prescribing, although the extent to which physicians receive stimulant marketing is not well described.

In the present study, the researchers analyzed data on physician and industry marketing interactions using the Open Payments database. They included nonresearch payments for both brand name and generic stimulants and determined the type, value and number of payments made overall, to providers by specialty and to individual providers.

Across 5 years, physicians received 591,907 payments that totaled more than $20 million. Of 989,789 physicians with data available, 55,105 received marketing payments. More than 97% of these payments came in the form of food and beverage and approximately 50% of the total amount of money spent was on food and beverage. The median payment was $14. Most marketing payments went to pediatricians as a group, with more than 19% receiving marketing related to stimulants. Psychiatrists received the most marketing in terms of dollar value for a total of 56.7% of the money spent, making them the second highest specialty receiving payments.

“As previous studies have shown, marketing — even its most subtle form — can influence prescribing, so doctors should be aware that even something as seemingly benign as a meal from a drug company could be affecting the clinical decisions they make,” Hadland said. – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.