A25 ASSOCIATION OF BIOLOGIC PRESCRIBING FOR INFLAMMATORY BOWEL DISEASE WITH INDUSTRY PAYMENTS TO PHYSICIANS
Bibliographic record
Abstract
Financial conflicts of interest (FCOIs) between the pharmaceutical industry and physicians have been associated with changes in prescribing behaviour, though the nature of this association in inflammatory bowel disease (IBD) is unknown. To investigate the relationship between the prescribing of biologic medications for IBD and industry payments to physicians from pharmaceutical companies making those medications. We used two US databases from 2013–2015: (1) The Centres for Medicare and Medicaid Services (CMS) Part D prescription claims database, which documents medications prescribed under Medicare; and (2) Dollars for Docs, which lists payments made by pharmaceutical companies to physicians. We identified physicians who prescribed biolgic medications for IBD and recorded industry payments physicians received from companies producing biologic medications in three categories: (1) Education; (2) Food and travel; and (3) other, such as speakers and consulting fees. A linear regression tested the association between payments received by a physician and dollar value of prescriptions written for biologics. A second regression was performed with an additional predictor variable to account for patient volume. 3475 gastroenterologists prescribed IBD biologics from 2013–2015. 3441 (99.0%) received at least one payment from a company producing the biologic medications they prescribed (Table 1). There was a significant association between the prescribing of biologics and the receipt of payments from companies making biologics (p<0.001; R2=6.49% ). For every $1000 in industry payments, there was an associated $2441 increase in prescription claims (95% CI: $2133 to $2748) (Figure 1). When accounting for patient volume, the associated prescription cost was significantly related to the value of industry payments (p<0.001, R2=7.64%). For every $1000 in industry payments, there was an associated $3846 increase in prescription claims (95% CI: $3285 to $4407). The strength of the association was similar for all three types of payments. There is an association between the receipt of industry payments from pharmaceutical companies making biologics for IBD, and the prescribing of those medications. These results highlight a potentially concerning influence of industry on prescribing behaviour. Payments from pharmaceutical companies making biologic medications to physicians with 11 or more associated prescription claims for those biologic medications, from 2013–2015 inclusive * Payment values in US dollars, per prescriber † Consulting fees, speakers’ fees, royalties, honoraria, and gifts SD, Standard deviation Relationship between industry payments and prescriptions for biologic medications. Total payments received by each physician are plotted on horizontal axis, while total cost associated with prescriptions written by each physician is plotted on the vertical axis. Payments are only counted if they are made by a company producing a medication that the receiving physician prescribes. None
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".