Industry Payments to Physicians Are Kickbacks. How Should Stakeholders Respond?

Area of Science:

• Health Policy
• Pharmaceutical Economics
• Medical Ethics

Background:

• Pharmaceutical industry payments to US physicians are widespread.
• The Anti-Kickback Statute (AKS) guidance from the Office of Inspector General (OIG) focuses on whether payments "sway" physician prescribing.
• Industry codes suggest permissible payments do not interfere with prescribing practices.

Purpose of the Study:

• To analyze the impact of pharmaceutical industry payments on physician prescribing patterns.
• To evaluate the potential for common industry payments to violate the AKS.
• To propose strategies for mitigating the cost-increasing effects of these payments.

Main Methods:

• Review of existing evidence on industry payments and prescribing behavior.
• Analysis of OIG guidance and industry codes of conduct.
• Examination of the economic consequences of influenced prescribing.

Main Results:

• Recent evidence indicates most industry payments influence physician prescribing.
• This influence drives increased use of brand-name and low-value drugs, raising healthcare costs.
• Many current payment practices may be subject to AKS prosecution.

Conclusions:

• The influence of industry payments on prescribing is substantial and costly.
• There is a public interest in curtailing payments that increase healthcare expenditures.
• Stakeholders should implement actions to mitigate the cost-increasing effects of industry payments to physicians.