The Association Between Opioid-Related Industry Payments and Opioid Prescribing at the Individual and Ecological Level in Pennsylvania

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Presentation: 4:36


Objective: to understand how industry payments related to opioid products are associated with opioid prescribing in Pennsylvania.

Methods: we merged the Open Payments data, Medicare Part D public use file, and Dartmouth Hospital Atlas of Health Care Hospital Service Areas from 2015 to analyze relationships between opioid related payments and opioid prescribing. We used a binomial regression model to investigate individual-level trends and a log-linear model to investigate Hospital Service Area-level trends. We mapped the distribution of opioid-related payments in Pennsylvania using GIS software.

Results: One additional payment to a physician was associated with 4.2% higher opioid-prescribing rate (OR = 1.0418, 95% CI 1.0416-1.0420, Chi-Square(1) = 122678, p<0.0001). One additional payment per physician in an HSA was associated with 79% more days of opioid filled on average by each HSA physician (IRR = 1.79, 95%CI 1.23-2.61, Chi-Square(1) = 9.17, p<0.0025).

Conclusions: We found a positive association between opioid-related payments to physicians and opioid prescribing. Policy makers and administrators should consider revising rules related to pharmaceutical company marketing tactics and promote judicious opioid prescribing.