A group of Johns Hopkins Medicine researchers recently conducted a lookback study of prescribing patterns among American ophthalmologists and optometrists, finding that those who received financial incentives from pharmaceutical companies were up to twice as likely to prescribe brand-name prostaglandin analogs (PGA) eyedrops for glaucoma than the generic versions.
In the study, the researchers examined payment claims from the Centers for Medicare and Medicaid Services (CMS) Part D beneficiary database and the CMS Open Payments database, ultimately finding more than 26,038 vision care professionals that prescribed glaucoma eyedrops in 2018 – 5,426 optometrists and 20,612 ophthalmologists. On average, practitioners prescribed 1,778 days’ worth of eyedrops during the study period. More than half (16,353 or 63%) did not receive payments from the makers of branded eyedrops.
Among the practitioners studied, 4,559 did not prescribe branded eyedrops while 17,480 prescribed branded eyedrops less than half the time and 3,999 practitioners\ prescribed branded eyedrops more than half the time.
In 2018, drug makers spent $5,060,346 on payments to practitioners who were part of the study and 92% of the funds went to only 25% of the participants. According to the study, the average range of amount paid to recipients in the study group was $24 to $147, with the average annual amount being $65 in 2018.
Upon analyzing the numbers, the study authors concluded that the practitioners who received a payment from a pharmaceutical company were almost twice as likely (1.8 times as likely) to prescribe branded eyedrops more than half the time when compared to practitioners who received no payments.
The study authors further concluded that even if they excluded the top 5% and 1% of practitioners who received payments, the link between payments and prescribing branded eyedrops remained. They also noted that the gender, location, or glaucoma specialty status were not associated with a higher frequency of prescribing branded eyedrops.
“We don’t know why certain clinicians more frequently prescribe high cost branded eyedrops when generics are generally just as good,” says Thomas Johnson III, M.D., Ph.D., the Allan and Shelley Holt Rising Professor in Ophthalmology at the Johns Hopkins University School of Medicine and Wilmer Eye Institute, who notes that the study was not designed to answer that question. “Perhaps frequent exposure to positive messaging about a drug influences this tendency, or prescribers feel compelled, consciously or subconsciously, to demonstrate their collegiality with pharmaceutical sales representatives.”