The opioid abuse epidemic in the U.S. has been linked to the aggressive marketing tactics that drug companies use with doctors, according to a new study.
What is happening?
The study, published in JAMA Network Open, examined county-specific federal data to determine where drug manufacturers focused their marketing efforts, according to lead researcher Dr. Scott Hadland, a pediatrician and addiction researcher at Boston Medical Center's Grayken Center for Addiction.
"The counties that had the most opioid product marketing from pharmaceutical companies were the counties that subsequently one year later had more opioid prescribing and had more opioid overdose deaths," Hadland told U.S.News & World Report.
Sometimes drug companies gained favor with doctors by spending relatively small amounts of money, according to the report. Buying a doctor a meal carried as much influence as "paying loads of cash to influential docs in the form of speaking or consultation fees."
For every three additional marketing payments given to doctors, opioid overdose deaths grew by 18 percent per 100,000 people in a county, researchers reported.
Some of the lawsuits and investigations into opioid manufacturers such as Purdue Pharma, the maker of OxyContin, tend to overlook some of the more subtle marketing efforts, according to Hadland.
"The investigators have focused on these large-value payments where a small number of doctors will get tens of thousands of dollars to help promote an opioid product," Hadland said told the news outlet.
The study, however, suggests "that the bigger public health problem is actually a much more subtle practice."
According to Hadland:
The dollar value of these payments is less important than the number of these marketing interactions that take place. The widespread practice of taking doctors out to lunch or dinner to talk about opioid products is probably contributing more to the opioid crisis in the U.S. than these less common instances of docs receiving really large-value payments.
During the lunches and dinners, pharmaceutical salespeople work to convince doctors that pain is under-treated. They also downplay the risk opioids carry for addiction and overdose, Linda Richter, director of policy analysis and research for the Center on Addiction in New York City, told the news outlet.
"Policymakers and state health regulators should prohibit licensed health professionals from accepting any such payments or incentives from the industry," Richter said. "Although physicians might believe that industry marketing efforts have no impact on their prescribing choices, a large body of evidence proves otherwise."
Heroin and fentanyl today are much more commonly involved in U.S. overdose deaths than prescription opioids, Hadland told U.S. News & World Report.
"Having said that, prescription opioids are still involved in about one-third of opioid overdose deaths, and they're commonly the first opioids people encounter before they start having a problem with addiction," he added.
How much is being spent?
Under the Affordable Care Act, pharmaceutical companies are required to report the amount they spend on drug marketing to the U.S. Centers for Medicare and Medicaid Services.
ACA data showed that pharma companies spent $39.7 million to market opioid medications to 67,507 doctors across 2,208 counties in the United States between August 2013 and December 2015. That included 434,754 payments in all, which ranged from the cost of a to "thousands of dollars in consulting fees," the news outlet reported.