Industry Payments to Oncologists: A Potential Influence on Treatment Choices?
A recent study published in the BMJ has sparked controversy by suggesting a potential link between industry payments to oncologists and the prescription of nonrecommended or low-value treatments. The study, led by Dr. Aaron P. Mitchell from the Department of Epidemiology and Biostatistics at Memorial Sloan Kettering Cancer Center, has been met with both concern and criticism from the medical community.
- The study found that patients of oncologists who received industry payments were more likely to be prescribed nonrecommended or low-value treatments.
- The research used Medicare claims data and the federal Open Payments database to identify correlations.
- The study has been criticized for not considering other factors that influence prescribing decisions, such as the role of pharmacy benefit managers and insurance coverage.
- The authors acknowledge that the study establishes an association and does not determine causality.
- Jeff Patton, MD, CEO of OneOncology and Chairman of the Board at Tennessee Oncology, criticizes the study for highlighting only one of two models that show a correlation. He also criticizes the study for labeling disagreement with the findings as “anger.”
- Ted Okon, CEO of the Community Oncology Alliance, argues that the study does not consider the influence of insurers and their pharmacy benefit managers (PBMs), which he believes play a significant role in prescribing patterns. He also mentions the influence of 340B hospital status on prescribing patterns.
- Both commentators express concern about any influence on oncologists’ choice of therapy for their patients, whether it be the influence of pharmaceutical industry payments, insurer/PBM utilization management mandates, 340B hospital status, or other factors. They argue for a more comprehensive approach to studying the factors influencing prescribing decisions.
[I]ronically enough, it’s mandated based on the profit incentive of the insurer and he PBM, not what is best for that patient. To take a position that these authors have stated over and over again and try to contrive research to fit what is their belief is nothing short of irresponsible. I was angry when I read it.
— Ted Okon, CEO of the Community Oncology Alliance
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