Background: While the rise in opioid analgesic prescribing and overdose deaths was multifactorial, financial relationships between opioid drug manufacturers and physicians may be one important factor.
Methods: Using national data from 2013 to 2015, we conducted a retrospective cohort study linking the Open Payments database and Medicare Part D drug utilization data. We created two cohorts of physicians, those receiving opioid-related payments in 2014 and 2015, but not in 2013, and those receiving opioid-related payments in 2015 but not in 2013 and 2014. Our main outcome measures were expenditures on filled prescriptions, daily doses filled, and expenditures per daily dose. For each cohort, we created a comparison group that did not receive an opioid-related payment in any year and was matched on state, specialty, and baseline opioid expenditures. We used a difference-in-differences analysis with linear generalized estimating equations regression models.
Results: We identified 6,322 physicians who received opioid-related payments in 2014 and 2015, but not in 2013; they received a mean total of $251. Relative to comparison group physicians, they had a significantly larger increase in mean opioid expenditures ($6,171; 95% CI: 4,997 to 7,346), daily doses dispensed (1,574; 95%CI: 1,330 to 1,818) and mean expenditures per daily dose ($0.38; 95% CI: 0.29 to 0.47). We identified 8,669 physicians who received opioid-related payments in 2015, but not in 2013 or 2014; they received a mean total of $40. Relative to comparison physicians, they also had a larger increase in mean opioid expenditures ($1,031; 95% CI: 603 to 1,460), daily doses dispensed (557; 95% CI: 417 to 697), and expenditures per daily dose ($0.06; 95% CI: 0.002 to 0.13).
Conclusions: Our findings add to the growing public policy concern that payments from opioid drug manufacturers can influence physician prescribing. Interventions are needed to reduce such promotional activities or to mitigate their influence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300290 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209383 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Utility of Candidate Genes From an Algorithm Designed to Predict Genetic Risk for Opioid Use Disorder.
JAMA Netw Open
January 2025
Mental Illness Research, Education and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
Importance: Recently, the US Food and Drug Administration gave premarketing approval to an algorithm based on its purported ability to identify individuals at genetic risk for opioid use disorder (OUD). However, the clinical utility of the candidate genetic variants included in the algorithm has not been independently demonstrated.
Objective: To assess the utility of 15 genetic variants from an algorithm intended to predict OUD risk.
Evaluation of Pain Relief and Opioid Consumption With the Addition of an Erector Spinae Plane Catheter Block After an Interscalene Nerve Block in Arthroscopic Rotator Cuff Repair.
Orthop J Sports Med
December 2024
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Background: The effects of the erector spinae plane (ESP) block and interscalene nerve block (ISNB) on arthroscopic rotator cuff repair (RCR) have been investigated separately.
Purpose: To evaluate whether additional catheterization for the ESP block can decrease acute postoperative pain and opioid consumption above the ISNB and multimodal oral analgesics in patients after arthroscopic RCR.
Study Design: Cohort study; Level of evidence, 3.
Are opioid use disorder assessments in the emergency department biased? An examination across sex, race, and employment status using item response theory.
Gen Hosp Psychiatry
December 2024
Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.
Background: In acute care settings such as the emergency department (ED), the absence of test bias is essential for any assessment. Unbiased assessments of the DSM-5 criteria for opioid use disorder (OUD) are crucial to ensure valid comparison of OUD severity, though focused tests of potential bias are lacking.
Method: This study used item response theory (IRT) to examine potential test bias across patient characteristics (i.
Management of opioid use disorder: 2024 update to the national clinical practice guideline.
CMAJ
November 2024
Department of Psychology and Neuroscience (Yakovenko, Belliveau, Fraleigh, Stewart); Department of Psychiatry (Yakovenko, Stewart), Dalhousie University, Halifax, NS; Research Centre of Centre Hospitalier de l'Université de Montréal (Mukaneza, Germé), Montréal, Que.; Department of Medicine (Bach, Wood), University of British Columbia; British Columbia Centre on Substance Use (Bach, Wood), Vancouver, BC; Waypoint Centre for Mental Health Care (Poulin); Department of Psychiatry (Poulin), University of Manitoba, Winnipeg, Man.; Addictions Divisions (Selby), Centre for Addition and Mental Health; Dalla Lana School of Public Health (Selby, Rehm), University of Toronto, Toronto, Ont.; Department of Family Medicine and Emergency Medicine (Goyer, Bruneau), Université de Montréal; Centre de recherche et d'aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-del'Île-de Montréal, Montréal, Que.; Division of General Internal Medicine (Brothers), Department of Medicine, Dalhousie University, Halifax, NS; Addiction Medicine Consult Service, Mental Health & Addictions Program (Brothers), Nova Scotia Health; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (Rehm), Toronto, Ont.; Department of Psychology (Hodgins), University of Calgary; Department of Psychology (Hodgins), Alberta Gambling Research Institute, Calgary, Alta.; Drug addiction service (Bruneau), Centre Hospitalier de l'Université de Montréal, Montréal, Que.
Article Synopsis
- - The 2024 update of the 2018 National Guideline for Clinical Management of Opioid Use Disorder emphasizes the need for current scientific evidence to inform treatment practices for opioid use disorder in Canada.
- - A comprehensive review from 2017 to 2023 was conducted to revise the guidelines, involving a national committee including those with personal experience in opioid use disorder, and ensuring quality through established methods.
- - Key changes in the recommendations include recognizing methadone and buprenorphine as equally effective first-line treatments, introducing slow-release oral morphine as a second-line option, and highlighting that psychosocial interventions should be optional rather than mandatory.
Payment and billing strategies to support methadone take-home medication: Perspectives of financial leaders of opioid treatment program organizations in New York State.
J Subst Use Addict Treat
January 2025
NYU Langone Health, 180 Madison Avenue, New York, NY 10016, United States. Electronic address:
Introduction: Recent federal regulatory changes governing the delivery of methadone treatment for opioid use disorder at Opioid Treatment Programs (OTPs) support continued practice changes towards greater and flexible methadone take-home medication. Existing payment models for OTPs were closely tied with onsite medication administration and thus misaligned with the need to conduct more and flexible take-homes. This study aims to understand OTP organizations' experience with the newly created OTP bundled payment model in New York State as an alternative to the pre-existing per-service payment model during 2020-2023 to inform financing strategies to support and sustain practice changes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!