How often do oncologists receive industry payments from competing companies?

Area of Science:

• Oncology
• Pharmaceutical Industry
• Medical Ethics

Background:

• Pharmaceutical payments to oncologists can impact prescribing habits.
• Physicians may believe payments from competing drug companies neutralize conflicts of interest.
• This study investigates the frequency of oncologists receiving payments for multiple competing cancer drugs.

Purpose of the Study:

• To determine how often oncologists receive industry payments for multiple, competing cancer drugs.
• To assess if receiving payments from multiple competing drug manufacturers balances potential bias.

Main Methods:

• Utilized CMS Part D Prescribers file (2017-2019) and Open Payments data.
• Included medical oncologists prescribing drugs within classes having multiple competitors.
• Analyzed payment receipt across 0, 1, 2, or 3 competing drugs and correlated with prescribing behavior.

Main Results:

• A minority of oncologists received payments for all three competing drugs in a class (1.6% for EGFR inhibitors, 25.3% for BCR-ABL TKIs, 34.3% for CDK4/6 inhibitors).
• Oncologists paid by multiple companies exhibited different prescribing patterns compared to unpaid peers.
• Specific examples include increased ribociclib vs. palbociclib prescriptions and decreased dasatinib prescriptions for those paid by all three drug companies.

Conclusions:

• While payments from all competing companies are infrequent overall, they represent a significant minority in certain drug classes.
• Industry payments from multiple competing drug manufacturers do not appear to neutralize conflicts of interest.
• Prescribing patterns differ between oncologists receiving competing payments and those who do not.