A bill is making its way through the California legislature that restricts pharmaceutical company gifts to medical professionals, with the goal of reducing conflicts that can affect patient care by influencing the prescription drugs a doctor prescribes.
California Senate Bill 790 severely restricts Big Pharma from providing consulting fees, entertainment, flights, and speaking fees, all of which can make medical professionals beholden to the provider.
SB 790 limits the amount drug makers can spend on a meal to $250.
While the bill initially restricted payments by a manufacturer or a wholesale distributor of medical devices, that was removed as part of a compromise. As it now stands, it only restricts payments from makers of prescription drugs, or biological products.
Most people deny conflicts can happen to them or that a casual meal can change the way they prescribe, but studies show that is exactly what happens.
The bill’s sponsor, California State Sen. Mike McGuire, cites a University of California, San Francisco study that found the perks make doctors two to three times more likely to prescribe costly brand-name drugs over generics.
That study was published in JAMA Internal Medicine in June, 2016.
Using the U.S. Open Payment database, established under the Sunshine Act, it matched Medicare prescribing with more than 276,000 doctors.
The researchers found when a generic drug was available for three cardiovascular drugs and one antidepressant, docs who received even one meal provided by industry, some valued under $20, prescribed the brand-name drug
Another study published by Harvard Medical School came to the same conclusion – Massachusetts doctors would prescribe a brand-name drug over a generic when there were gifts involved.
Feeding doctors is not uncommon.
In the Mass. study, among the 2,444 physicians in the Medicare database, more than one-third (36.8%) received industry payments in the form of company-sponsored meals.
Independent investigative journalists from ProPublica, looked at doctors nationwide and found, in the case of cholesterol-fighting statins, prescriptions increased by 0.1 percent for every $1,000 of industry money spent on meals.
That can amount to a real boost for industry since statins cost anywhere from two to four times the cost of generics.
All of this is occurring at a time when the U.S. is trying to rein in the cost of prescription drugs. According to the Senator’s office, every year the U.S. spends $73 billion on brand name drugs when there are generic equivalents available at a lower cost.
Taxpayers are picking up the difference since Medicare pays for one out of every four prescriptions.
As a way of explanation, Big Pharma says its speaking programs that educate physicians provides value.
Looking at other states – Massachusetts passed a similar bill curtailing speaking fees and travel. However, once restaurants chimed in, that state loosened the meal restriction.
Minnesota and Vermont both cap gifts and food to doctors at $50 per year. Speaking fees must be “reasonable” and only for “bonafide” educational purposes.
California physicians receive more pharmaceutical gifts and payments than doctors in any other state, according to the senator’s office, taking in $1.4 billion in 2014.
SB 790 will move to the California Assembly.
It is opposed by industry groups including PhRMA.
