In 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time. Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid. “This is the first time we’ve seen this, and it’s really important,” said Dr. Andrew Kolodny, a senior scientist at the Institute for Behavioral Health at the Heller School for Social Policy and Management at Brandeis University, where he is co-director of the Opioid Policy Research Collaborative. “It smells like doctors being bribed to sell narcotics, and that’s very disturbing,” said Kolodny, who is also the executive director of Physicians for Responsible Opioid Prescribing. The Harvard researchers said it’s not clear whether the payments encourage doctors to prescribe a company’s drug or whether pharmaceutical companies seek out and reward doctors who are already high prescribers. “I don’t know if the money is causing the prescribing or the prescribing led to the money, but in either case, it’s potentially a vicious cycle. It’s cementing the idea for these physicians that prescribing this many opioids is creating value,” said Dr. Michael Barnett, assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health.
The CNN/Harvard analysis looked at 2014 and 2015, during which time more than 811,000 doctors wrote prescriptions to Medicare patients. Of those, nearly half wrote at least one prescription for opioids.
Fifty-four percent of those doctors — more than 200,000 physicians — received a payment from pharmaceutical companies that make opioids.
Doctors were more likely to get paid by drug companies if they prescribed a lot of opioids — and they were more likely to get paid a lot of money.
Among doctors in the top 25th percentile of opioid prescribers by volume, 72% received payments. Among those in the top fifth percentile, 84% received payments. Among the very biggest prescribers — those in the top 10th of 1% — 95% received payments. Barnett, one of the Harvard researchers who worked with CNN, said pharmaceutical companies pay doctors for a reason. “It’s not like they’re spending this money and just letting it go out into the ether,” he said. “They wouldn’t be spending this money if it weren’t effective.”