In the United States, deaths from opioid overdoses continue to rise, both from illegally distributed heroin and fentanyl, but also from prescription opioids given by doctors. Currently, prescription opioids are related to 40% of all opioid overdoses here in the US, and are the first type of opioid that many people get before they move onto using illegal opioids. Doctors in the United States prescribe three times more opioids today than in 1999, and those levels are still very high even in regions where many people are dying from opioid overdoses.
When pharmaceutical companies directly market drugs to doctors, the rates of doctors prescribing those drugs increase. However, it is not well known if deaths from prescription opioid overdoses are associated with pharmaceutical companies marketing these opioids directly to doctors. Therefore, researchers from around the country looked at data that was collected from the Centers for Disease Control and the Centers for Medicare and Medicaid Services Open Payments between 2013 and 2015 to try and answer this question.
The researchers found that between August of 2013 and December of 2015, there were over 430,000 payments totaling $39.7 million in non-research based opioid marketing distributed to over 67,000 doctors across 2208 United States counties. When the opioid marketing increased (which included marketing value, number of payments to physicians, and number of physicians receiving opioid marketing), the deaths from prescription opioid overdoses also increased. Also, when the opioid marketing increased, the rates of doctors prescribing opioids also increased. Therefore, this means that counties in the United States who received increased opioid marketing from pharmaceutical companies had increased numbers of deaths due to prescription opioid overdoses. Interestingly, the researchers found that the number of payments made to doctors and the number of doctors receiving payments affected the increased rates of prescribing opioids and the increased mortality from overdoses more than just the dollar amount of payments and marketing. This could mean that the effect they saw from the pharmaceutical marketing was from a low monetary level of payment over a very large scale.
As the United States moves forward to reducing the number of overdoses from all types of opioids, it might be worth taking a look at limiting the widespread marketing pharmaceutical companies can give directly to doctors, as that seems to increase not only the amount of opioids doctors prescribe, but also the number of deaths from prescription opioid overdoses.
Edited By: Gina Riggio
Publication Date: January 18th, 2019
Paper Author(s): Scott E. Hadland, MD, MPH, MS; Ariadne Rivera-Aguirre, MPP; Brandon D. L. Marshall, PhD; Magdalena Cerdá, DrPH, MPH
Paper Institution(s): Boston University School of Medicine, Boston Medical Center, University of California at Davis, Sacramento, New York University School of Medicine, Brown University School of Public Health