You are using an outdated browser. Please upgrade your browser to improve your experience.
Become a Fellow
ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
Earn MOC points
The most comprehensive meeting in Internal Medicine.
April 11-13, 2019
Internal Medicine Meeting 2019
Prepare for the Certification and Maintenance of Certification (MOC)
Exam with an ACP review course.
Board Certification Review Courses
MOC Exam Prep Courses
Treating a patient? Researching a topic? Get answers now.
Visit AnnalsLearn More
Visit MKSAP 18Learn More
Visit DynaMed Plus
Ensure payment and avoid policy violations. Plus, new resources to help you navigate the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
© Copyright 2018 American College of Physicians. All Rights Reserved. 190 North Independence Mall West, Philadelphia, PA 19106-1572
Toll Free: (800) 523.1546 · Local: (215) 351.2400
First Author: Colette Dejong, BA (1).
Additional Authors: Thomas Aguilar, MS (1), Chien-Wen Tseng, MD, MPH (2), Grace A. Lin, MD, MAS (1), and R. Adams Dudley, MD, MBA (1).
1. University of California, San Francisco.
2. University of Hawaii.
Background: In 2009, 84% of American physicians reported receiving meals, gifts, or payments from the pharmaceutical industry. Although industry-sponsored meals and honoraria may create opportunities for physicians to discuss new therapies, past studies using self-reported data have raised concerns about their potential to influence prescribing behavior. We used recently released data from the U.S. Sunshine Act to conduct the first national, physician-level analysis of the association between industry-sponsored meals and honoraria and physician prescribing patterns.
Methods: In this retrospective cohort study, we linked U.S. Sunshine Act data with prescribing data from Medicare Part D. We identified physicians who wrote prescriptions in any of four drug classes: selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs and SNRIs), ß-blockers, angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers (ACEis and ARBs), and statins. We identified the most-prescribed branded drug in each class (desvenlafaxine, nebivolol, olmesartan, and rosuvastatin, respectively), and used Sunshine Act data to flag physicians who received meals or payments for that drug from August-December 2013. Multivariate logistic regression was used to compare prescribing rates of each drug relative to alternatives, among physicians who received meals or payments and physicians who did not. Sensitivity analyses were conducted using propensity-score matching. We excluded research-related and royalty payments, and adjusted for physician-level demographic characteristics, specialty, and practice setting.
Results: 279,669 sample physicians received 63,524 payments associated with the four drugs, totaling $1.4 million. Sponsored meals constituted 95% of target payments, and averaged under $20. Physicians receiving one sponsored meal for the drug of interest had significantly higher rates of prescribing desvenlafaxine over other SSRIs or SNRIs (odds ratio 2.18, 95% confidence interval 2.13 to 2.23), nebivolol over other ß-blockers (1.70, 95% CI 1.69 to 1.72), olmesartan over other ACEis or ARBs (1.52, 95% CI 1.51 to 1.53), and rosuvastatin over other statins (1.18, 95% CI 1.17 to 1.18). The association was dose-dependent, with additional meals and costlier meals associated with greater increases in relative prescribing rates (p<0.001). Results were similarly significant in propensity-matched cohorts. Physicians receiving honoraria, which averaged $1,065, were significantly more likely to prescribe the targeted drug over alternatives (odds ratios of 1.20 to 2.03 across the four drugs studied, p<0.001)
Conclusions: Sponsored meals or honoraria from a drug’s manufacturer are associated with increased prescribing of that drug relative to alternatives. Further investigation of physician-industry relationships is needed to determine their potential impact—positive or negative—on healthcare costs and patient outcomes.
Want to have your Abstract featured here? ACP holds a National Abstracts Competition as part of the ACP Internal Medicine Meeting every year. Find out more about the ACP National Abstract Competition.
Back to February 2017 Issue of IMpact