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Study: Physician-Targeted Marketing Contributes to Opioid Overdoses
USAgNet - 01/22/2019

Many individuals cite prescription opioids as their gateway to illicit opioid use. However, while prescription opioids are involved in more than one-third of all opioid overdose deaths in the U.S., examining any correlation between prescription opioid overdose deaths and pharmaceutical industry marketing has been limited -- until now.

New research from NYU School of Medicine and Boston Medical Center published online in JAMA Network Open shows that increased marketing of opioid products to physicians -- from consulting fees to free meals -- is associated with higher opioid prescribing rates and elevated overdose deaths in the U.S.

"Prescription opioids contribute to more than 17,000 overdose deaths annually in the U.S. Our findings suggest an urgent need to examine the role the pharmaceutical industry marketing plays in the national opioid crisis," said Magdalena Cerdá, DrPH, associate professor of Population Health and director of the Center for Opioid Epidemiology and Policy at NYU School of Medicine, and the study's senior author. "Data suggest that when physicians are targeted in opioid marketing, they prescribe more opioids. This, consequently, impacts on opioid overdose deaths."

Cerdá and her co-investigators determined that $39.7 million in opioid marketing was distributed to almost 68,000 physicians in 2,208 U.S. counties. Direct-to-physician marketing includes a pharmaceutical company paying for physicians' meals, travel costs, speaking fees, honoraria, or consulting fees.

Counties that received more industry marketing saw an increase in opioid prescribing -- and experienced higher opioid overdose deaths. The researchers also found that the number of marketing interactions with physicians was more strongly associated with overdose deaths than the amount spent. In fact, for every three additional payments made to physicians per 100,000 people in a county, opioid overdose deaths were 18 percent higher.

The study linked information from 2013 to 2016 across three national databases: the Open Payments database, which includes all payments made by pharmaceutical companies to physicians; Centers for Disease Control and Prevention (CDC) data drug overdose data from all 50 states and DC; and CDC data on opioid prescriptions dispensed at pharmacies. It also measured opioid marketing in three different ways: the total dollar value of marketing received by physicians; the number of payments made by the pharmaceutical industry; and the number of physicians receiving any marketing.

Results suggest that the greatest influence of pharmaceutical companies may be more subtle and widespread -- such as payments of low monetary value occurring on a very large scale. For example, the team's findings indicate that the provision of inexpensive yet multiple meals for marketing purposes may be influencing a physician's prescribing pattern more than single high-value speaking fees, resulting in more numerous overdose deaths in the future.

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