Physicians prescribe fewer branded drugs when hospitals limit drug rep interactions

Physicians at teaching hospitals that restrict drug representative interactions prescribed fewer promoted brand name drugs than peers at hospitals without restrictions, according to a study published in JAMA.

Here are five things to know.

1. For the study, researchers examined the restriction practices at 19 teaching hospitals in five states. While restrictions varied by hospital, rules included forbidding drug reps from freely walking the halls and barring them from giving physicians meals or gifts, reports NPR.

2. Researchers compared prescriptions from 2,126 physicians at the 19 hospitals to prescriptions written by 24,593 physicians at hospitals that don't limit drug rep interactions. Researchers examined more than 16 million prescriptions written between January 2006 and June 2012 using data from CVS Caremark.

3. When comparing prescriptions before and after restrictions were implemented, researchers found significant differences for six of the eight drug classes studied and at nine of the 19 hospitals. Prescribing changes occurred immediately after policy implementation and stayed consistent for the next 12 to 36 months, according to researchers.

4. Before the policies were implemented, the average promoted drug had a market share of 19.3 percent. Implementing a policy to limit drug marketing was linked to a 1.67 percentage point decrease in that market share, as physicians prescribed more generic drugs instead. Hospitals with stricter policies saw even larger decreases.

5. Researchers note the study highlights an association between drug rep restrictions and prescribing — not a causal relationship. Yet the study still demonstrates the importance of limiting drug company marketing in teaching hospitals to ensure there's "no inappropriate influence over prescribing," Howard Bauchner, MD, JAMA's editor-in-chief, told NPR.

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