British Medical Journal (The BMJ)Pharmaceutical Industry Payments and Delivery of Non-recommended and Low Value Cancer Drugs: Population-based Cohort Study

Industry Payments to Oncologists Linked to Delivery of Non-Recommended Cancer Drugs

A recent cohort study has investigated the potential influence of pharmaceutical industry payments on the delivery of non-recommended or low value interventions in cancer treatment. The study provides valuable insights into the financial relationships between physicians and the industry, and their potential impact on patient care.

Study Design

• The study was a cohort study conducted using fee-for-service Medicare claims.
• Participants were Medicare beneficiaries diagnosed with incident cancer during 2014-19.
• The study focused on four non-recommended or low value interventions: denosumab for castration sensitive prostate cancer, granulocyte colony stimulating factors (GCSF) for patients at low risk for neutropenic fever, nab-paclitaxel for cancers with no evidence of superiority over paclitaxel, and a branded drug in settings where a generic or biosimilar version was available.

Key Findings

• Oncologists received industry payments for 30.2% of patients at risk for non-recommended denosumab, 28.3% for GCSF, 21.4% for nab-paclitaxel, and 31.2% for branded drugs.
• Patients whose oncologists received payments were more likely to receive non-recommended denosumab, GCSF, and nab-paclitaxel, but less likely to receive branded drugs.
• After controlling for patients’ characteristics and calendar year, industry payments were associated with increased use of denosumab, GCSF, and nab-paclitaxel, but lower use of branded drugs.

According to a report by ProPublica, doctors who received payments from the medical industry were more likely to prescribe brand-name drugs at higher rates than others in their specialty.

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