Study finds docs suceptible to lunches, patient demands for branded drugs

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The doctors who said back 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 a few samples further enhances 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, and more experienced doctors -- those in businesses for at least 30 years -- 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 among those 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 regular sore point for those trying to hold down drug costs. Critics say the goal has been regularly undermined by strategies such as co-pay cards, which offer drugmakers an end run around higher copays meant to discourage use of the more expensive drugs.

A December report by the Employee Benefit Research Institute reinforces the link between financial pain and patient behavior. Findings by the group, 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 “cost” of coupon cards is patient adherence, which can prevent the need for more expensive care down the line.

The study researchers' proposals for fixing the 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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