Study: free lunches can hurt generics

Lisa Iezzoni, one of the study's authors
Lisa Iezzoni, one of the study's authors

The doctors who said in 2012 that drug company-sponsored lunches couldn't sway their prescribing are being undercut by a study published in JAMA's Internal Medicine.

Among the findings: giving doctors meals at workplace “up-to-date” meetings where reps and physicians talk product increases the likelihood that doctors will prescribe branded drugs over generics. The researchers found that tossing in samples adds to a physician's brand bias.

Researchers found that woo-ability is linked to additional factors: small-practice docs were more likely than those in hospital or medical school settings to bend to a patient's request for branded drugs over generics. More experienced doctors were also more inclined to give in to patients asking for name brand therapies.

Researchers noted that pushback against brand requests had strong trendlines, with pediatricians, cardiologists and general surgeons being less likely to abandon generics despite patient requests, compared to internists, who were more likely to comply.

Patient demand for branded drugs has been a sore point for those trying to hold down drug costs. Critics say the goal has been undermined by tactics such as co-pay cards, which offer drugmakers an end run around higher copays meant to discourage use of the more costly drugs.

A December report by the Employee Benefit Research Institute—whose members include insurers such as Unitedhealth, Wellpoint and Aetna as well as companies like General Mills and FedEx—showed that employees who carried a greater financial burden for their medical costs through CDHP health plans were more likely to request generics over brand names.

Card supporters counter that the cards promote patient adherence, which can prevent more expensive care down the line.

The study researchers' proposals to change brand-over-generic behaviors are familiar to doctors in Accountable Care Organizations and the pharmaceutical agencies that are learning how to navigate them: route samples to a central pharmacy instead of individual doctors. They also suggest banning company-sponsored meals.
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