Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Poster Number

79

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Health Policy and Management

Keywords

pharmaceutical marketing, health policy, healthcare cost, diabetes

Publication Date

4-2017

Abstract

Background: Growth in pharmaceutical expenditures for diabetes outpaced growth in diabetes prevalence. Prescribers accepting gifts and meals from pharmaceutical companies have been linked with higher prescription rates and costs[1]. Pharmaceutical marketing to these prescribers and patients often promotes newer, more expensive drugs, such as the GLP-1 analogues and SGL-2 inhibitors. These two drug classes are more expensive but no more effective than metformin,[2] the recommended first-line treatment for diabetes, and the oldest and cheapest available treatment. We investigated how cost of diabetes treatment was affected by marketing practices in the District of Columbia.

Methods: The AccessRx program in DC requires pharmaceutical companies to report gifts given to healthcare providers, drug advertising expenses, and the salaries for staff engaged in promotional activities (“detailing expenses”). We combined data from AccessRx and the federal Open Payments system to estimate promotional payments. We used Medicaid drug utilization data to examine spending for diabetes treatment.

Results: In 2014, DC Medicaid spent more than $17.1 million on pharmaceutical treatments for diabetes. We estimated that ten companies spent $3.8 million in detailing expenses to market diabetes drugs in 2014. SGLT-2 inhibitors and GLP-1 analogues had the highest estimated detailing expenses, each totaling more than $1.2 million. From 2014 to 2015, DC Medicaid spending for Victoza (liraglutide), a GLP-1 analogue, increased 51% (from $183,873 to $362,230) and Invokana (canaglifozin), a SGLT-2 inhibitor, increased 213% (from $8,933 to $27,958).

Conclusions: Pharmaceutical promotion drives unnecessary use of newer, more expensive medications. The District of Columbia should provide education on rational prescribing for diabetes treatment (including diet and exercise).

[1] Perlis RH, Perlis CS. Physician payments from industry are associated with greater Medicare Part D prescribing costs. PLoS One. 2016;11(5):e0155474.

DeJong C, Aguilar T, Tseng CW, et al. Pharmaceutical industry-sponsored meals and physician prescribing patterns for Medicare beneficiaries. JAMA Intern Med. 2016;176(8):1114-10.

[2] Prescrire International. Hypoglycaemic therapy in type 2 diabetics. Prescrire Int. 2015 Apr;24(159):103- 106.

Prescrire International. Glucose-lowering treatment of type 2 diabetics. Prescrire Int. 2015 May;23(160):130-135.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

1

Comments

Poster presented at GW Annual Research Days 2017.

This poster is the winner of the Policy and Practice Import Award.

 

Promotion of New Diabetes Products in the District of Columbia

Background: Growth in pharmaceutical expenditures for diabetes outpaced growth in diabetes prevalence. Prescribers accepting gifts and meals from pharmaceutical companies have been linked with higher prescription rates and costs[1]. Pharmaceutical marketing to these prescribers and patients often promotes newer, more expensive drugs, such as the GLP-1 analogues and SGL-2 inhibitors. These two drug classes are more expensive but no more effective than metformin,[2] the recommended first-line treatment for diabetes, and the oldest and cheapest available treatment. We investigated how cost of diabetes treatment was affected by marketing practices in the District of Columbia.

Methods: The AccessRx program in DC requires pharmaceutical companies to report gifts given to healthcare providers, drug advertising expenses, and the salaries for staff engaged in promotional activities (“detailing expenses”). We combined data from AccessRx and the federal Open Payments system to estimate promotional payments. We used Medicaid drug utilization data to examine spending for diabetes treatment.

Results: In 2014, DC Medicaid spent more than $17.1 million on pharmaceutical treatments for diabetes. We estimated that ten companies spent $3.8 million in detailing expenses to market diabetes drugs in 2014. SGLT-2 inhibitors and GLP-1 analogues had the highest estimated detailing expenses, each totaling more than $1.2 million. From 2014 to 2015, DC Medicaid spending for Victoza (liraglutide), a GLP-1 analogue, increased 51% (from $183,873 to $362,230) and Invokana (canaglifozin), a SGLT-2 inhibitor, increased 213% (from $8,933 to $27,958).

Conclusions: Pharmaceutical promotion drives unnecessary use of newer, more expensive medications. The District of Columbia should provide education on rational prescribing for diabetes treatment (including diet and exercise).

[1] Perlis RH, Perlis CS. Physician payments from industry are associated with greater Medicare Part D prescribing costs. PLoS One. 2016;11(5):e0155474.

DeJong C, Aguilar T, Tseng CW, et al. Pharmaceutical industry-sponsored meals and physician prescribing patterns for Medicare beneficiaries. JAMA Intern Med. 2016;176(8):1114-10.

[2] Prescrire International. Hypoglycaemic therapy in type 2 diabetics. Prescrire Int. 2015 Apr;24(159):103- 106.

Prescrire International. Glucose-lowering treatment of type 2 diabetics. Prescrire Int. 2015 May;23(160):130-135.

 

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