There are many ways to treat cancers of all kinds, and patients rely on their oncologists to pick the appropriate medication for them.
But a new study uncovers more evidence that doctors are more likely to prescribe certain drugs if they received kick-backs like free meals and travel fares from the manufacturers.
Analyzing data on patients with two types of cancers, they found oncologists were twice as likely to treat them with a drug if they had a financial relationship with the provider.
The prevalent trend is nothing new, but researchers warn this study showing unwavering correlation between doctors’ payoffs and their patients’ treatment is cause for concern.
There was a stark increase in prescriptions for drugs after doctors received kickbacks from the manufacturer. The only anomaly was for Imatinib (pictured), but the researchers discovered this was for a reason: Imatinib was about to lose its patent protection, so the company was urging doctors to switch over to the alternative, Nilotinib, and start phasing out Imatinib
The study, published today in the Journal of the American Medical Association (JAMA), did not look at whether the chosen drugs were worse or better for the patient.
But, the researchers warned, the issue is more that patients may not be aware that any factors other than their well-being are taken into account.
‘The main takeaway is that oncologists who received money from a pharmaceutical company were more likely to choose that company’s drug the following year,’ said Aaron Mitchell, MD, a fellow in the UNC School of Medicine Division of Hematology & Oncology, and the study’s lead author.
To assess how strongly influenced oncologists were by kickbacks, researchers analyzed prescriptions for Medicare patients with two cancers: metastatic renal cell cancer of the kidneys, and chronic myeloid leukemia, which affects blood cells.
Each can be treated with various medications.
Dr Mitchell and his team analyzed publicly available data on Open Payments from 2013 to 2014.
The Affordable Care Act database required manufacturers to publish all payments to physicians and teaching hospitals which exceeded $10.
The differences were stark.
Those who did get kickbacks, covering anything from meals to accommodation for a meeting, were up to 100 percent more likely to prescribe that company’s drug for either cancer.
In the metastatic renal cell cancer group, oncologists who received payments were twice as likely to prescribe that firm’s medication. For chronic myeloid leukemia, doctors who received any payment were 29 percent more likely to prescribe that firm’s drug.
They were also more likely to reduce prescriptions of drugs which were coming to the end of their patent, switching over to a different supply from the same company in a way that would protect that company’s profits.
For example, the researchers found a huge decrease (statistically-speaking) in the use of the leukemia drug imatinib after doctors received kickbacks from that drug’s manufacturer.
Digging further, they found that imatinib was on the cusp of losing its patent protection.
As it happened, the same manufacturer also provided another treatment, nilotinib, which was subsequently over-prescribed.
Dr Mitchell said he believes this suggests that the company was invested in encouraging doctors to switch over from the older drug to the newer drug.