A Colorado School of Public Health researcher has found that lawsdesigned to illuminate financial links between doctors andpharmaceutical companies have little or no effect on what drugsphysicians prescribe. “If the policymakers who passed these measures were hoping for adeterrent effect they may be disappointed,” said the study’s leadauthor, Genevieve Pham-Kanter, Ph.D., an assistant professor in theDepartment of Health Systems, Management and Policy at the ColoradoSchool of Public Health and a research fellow at Harvard Universityand Massachusetts General Hospital. The report, published in the Archives of Internal Medicine , was prompted by passage of the Physician Payments SunshineProvision of the Affordable Care Act. The new federal law requires drug manufacturers to disclose certainpayments made to physicians including money for consulting,honoraria, gifts and travel. “This law is based on the premise that transparency in thesetransactions is of public importance and that disclosurerequirements can act as a deterrent against quid pro quo exchanges- physicians may be reluctant to accept large payments frompharmaceutical firms if payments are publicly known and perceivedas financial compensation for prescribing certain therapies,” saidPham-Kanter who is also an assistant professor of economics at theUniversity of Colorado Denver. Ericsson AXE 10
Working with Kavita Nair, Ph.D., associate clinical professor atthe University of Colorado Skaggs School of Pharmacy andPharmaceutical Sciences and G. Caleb Alexander, MD, MS, JohnsHopkins Bloomberg School of Public Health, Pham-Kanter examinedWest Virginia and Maine, two states with disclosure laws already onthe books. She specifically investigated the effect of the laws on theprescribing of HMG-CoA reductase inhibitors (statins) and selectiveserotonin reuptake inhibitors (SSRIs). Marketing plays a heavy rolein a physician’s choice of therapy since members of each class ofdrug are similar and highly substitutable, Pham-Kanter said. The researchers theorized that if disclosure laws were effectiveand doctors were deterred from taking payments from pharmaceuticalcompanies, they in turn would be less likely to prescribe brandedstatins and SSRIs over similar generic drugs. Nortel S8000
Using a wide variety of public data, they compared Maine, whichenacted a disclosure law in 2004, with New Hampshire and RhodeIsland, two demographically similar states without such laws. Thenthey compared West Virginia, which also passed its disclosure lawin 2004, with Kentucky and Delaware which had none. In Maine, the law was associated with a 0.8 percentage pointreduction in the use of branded statins compared to New Hampshire,and a 5.3 percentage point reduction compared to Rhode Island. Theresearchers found little to no effect in West Virginia. China Nokia Ultrasite
“Our results show that the disclosure laws in the two states weexamined had a negligible to small effect on physicians switchingfrom branded therapies to generics and no effect on reducingprescription costs,” said Pham-Kanter. She noted that despite the laws, accessing information about howmuch money a physician received from a pharmaceutical company isstill difficult and opaque. Much of the information is not on-lineyet. “Transparency is important in its own right, but if deterringunnecessary, costly prescribing is a concern for policymakers, moredirect action may be required,” Pham-Kanter said.
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