Journal of General Internal Medicine

, Volume 34, Issue 7, pp 1074–1076 | Cite as

Association of Pharmaceutical Manufacturer Payments to Physicians and Prescribing Dosage of Opioids

  • William FleischmanEmail author
  • Shantanu Agrawal
  • Cary P. Gross
  • Joseph S. Ross
Concise Research Reports


Pharmaceutical manufacturers spend billions of dollars annually on payments to physicians in the form of food, gifts, educational materials, and speaker and consulting fees. Payments related to brand-name cardiovascular and diabetes drugs have recently been associated with higher rates of prescribing, despite lower-cost alternatives being available.1, 2, 3 Given the growing misuse of prescription opioids and accompanying public health risks, we used Centers for Medicare & Medicaid Services Open Payments data, along with Medicare Part D prescribing data, to examine associations between opioid-related payments from pharmaceutical manufacturers to physicians and opioid prescribing. We assessed both average prescribed dose and whether the prescribed dose exceeded Centers for Disease Control and Prevention (CDC) opioid dosage recommendations.4


We included opioid-related non-research payments from pharmaceutical manufacturers to doctors of medicine,...


Authors’ Contributions

WF and JSR conceived and designed the study, assisted by all authors. WF acquired the data and performed analyses and interpretation with the assistance of all authors. WF drafted the manuscript and all authors critically revised it. JSR supervised the study.

Compliance with Ethical Standards

Conflict of Interest

At the time of writing, Drs. Fleischman and Agrawal were employees of the Centers for Medicare & Medicaid Services, which administers the Open Payments program. Drs. Gross and Ross receive support through Yale University from Johnson and Johnson to develop methods of clinical trial data sharing. Dr. Gross receives funding from 21st Century Oncology and the National Comprehensive Cancer Center-Pfizer program for research. Dr. Ross receives support through Yale University from the Centers of Medicare and Medicaid Services to develop and maintain performance measures that are used for public reporting, from Medtronic, Inc. and the Food and Drug Administration (FDA) to develop methods for post-market surveillance of medical devices, from the Food and Drug Administration as part of the Centers for Excellence in Regulatory Science and Innovation (CERSI) program, from the Blue Cross Blue Shield Association to better understand medical technology evaluation, and from the Laura and John Arnold Foundation to support the Collaboration on Research Integrity and Transparency (CRIT) at Yale.


The views expressed in this article are those of the authors and do not necessarily represent the views of the Centers for Medicaid & Medicare Services, the Department of Health and Human Services, or the United States Government.


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Copyright information

©  Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  • William Fleischman
    • 1
    • 2
    Email author
  • Shantanu Agrawal
    • 2
    • 3
  • Cary P. Gross
    • 4
    • 5
  • Joseph S. Ross
    • 4
    • 5
    • 6
  1. 1.Department of Patient Safety & QualityHackensack Meridian HealthEdisonUSA
  2. 2.Centers for Medicare & Medicaid ServicesBaltimoreUSA
  3. 3.National Quality ForumWashington, DCUSA
  4. 4.Section of General Internal Medicine, Department of MedicineYale School of MedicineNew HavenUSA
  5. 5.Department of Health Policy and ManagementYale School of Public HealthNew HavenUSA
  6. 6.Center for Outcomes Research and EvaluationYale-New Haven HealthNew HavenUSA

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