Pharmaceutical industry marketing of opioid products to physicians through non-research payments, which can include speaking fees and meals, was associated with greater opioid prescribing in a recent JAMA Internal Medicine article.

Many opioid-related overdose deaths involve prescription opioids, and prescription opioids are often a person's first encounter, a gateway, to illicit use.

Due to changes in government rules, marketing by the pharmaceutical industry directly to the public and  physicians has become widespread but marketing of opioids and its influence on prescribing is unclear. In the old days, doctors would only learn about new drugs outside patient hours. So a company would buy a table at a restaurant and have dinner with the doctors. Do doctors really get influenced by a free dinner? The evidence was unclear but companies certainly promoted that notion using lobbyists - and so direct-to-consumer marketing came to be. Now people go to the doctor demanding a specific brand name medication because they saw it on TV and read about it in Town&Country magazine.

The new analysis resulted from linking of two U.S databases to identify all non-research payments from the pharmaceutical industry to physicians marketing opioid products (excluding buprenorphine hydrochloride marketed for addiction treatment) and to gather information on all claims from physicians who wrote opioid prescriptions (initial or refill) filled for Medicare beneficiaries in 2015. They concluded that the payments were correlated.

 The study has limitations, such as the possibility of reverse causation because physicians who receive industry payments may already have been inclined to prescribe opioids, such as if they are pain doctors with a lot of cancer patients. This paper establishes association, not cause and effect 

Citation: Scott E. Hadland, MD, MPH, Magdalena Cerdá, DrPH, MPH; Yu Li, MD, PhD; Maxwell S. Krieger, BS; Brandon D. L. Marshall, PhD, 'Association of Pharmaceutical Industry Marketing of Opioid Products to Physicians With Subsequent Opioid Prescribing', JAMA Intern Med. May 14, 2018. doi:10.1001/jamainternmed.2018.1999