The Relationship of Industry Payments to Prescribing Behavior: A Study of Degarelix and Denosumab.
BACKGROUND
The influence of financial ties to pharmaceutical companies remains controversial. We aimed to assess a potential relationship between pharmaceutical payments and prescription patterns for degarelix and denosumab.


METHODS
Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (Medicare B) data containing 2012 claims compared to OpenPayments (Sunshine Act) data for the second half of 2013. Urologists and medical oncologists who billed Medicare for degarelix or denosumab were cross referenced in both databases and payments were aggregated into a consolidated dataset. Adjusted beneficiary count and total Medicare reimbursement were compared according to receipt of Sunshine payment, and an association between Sunshine payment amount and total Medicare reimbursement was also assessed.


RESULTS
Of the 160 prescribers of degarelix and 1,507 prescribers of denosumab, 91 (57%) and 854 (57%) received Sunshine payment, respectively. Degarelix prescribers who received Sunshine payment had higher median total Medicare reimbursement ($13,257 vs. $9,554,p= 0.01). Denosumab prescribers who received Sunshine payment had both higher median adjusted beneficiary count (55 vs. 50,p< 0.001) and median total Medicare reimbursement ($69,620 vs. $60,732,p< 0.001). On multivariable analysis, both receipt of Sunshine payment (adjusted median difference $5,844, 95% CI $937 - $10,749) and oncology specialty (adjusted median difference $34,380, 95% CI $26,715 - $42,045) were independently associated with total Medicare reimbursement for denosumab.


CONCLUSIONS
In the case of degarelix and denosumab, there is a weak association between pharmaceutical company payments on prescribers' prescription behavior patterns.
Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA 15213.
Jathin
J
Bandari
Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA 15213.
Robert M
RM
Turner
Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA 15213.
Bruce L
BL
Jacobs
Lahey Institute of Urology, Lahey Hospital and Medical Center, Burlington, MA, USA 01805.
David
D
Canes
Lahey Institute of Urology, Lahey Hospital and Medical Center, Burlington, MA, USA 01805.
Ali
A
Moinzadeh
Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA 15213.
Benjamin J
BJ
Davies
degarelix; denosumab; medicare; prescriber payments; sunshine act