BY JESSICA WAPNER
FOR PEOPLE wondering where their out-ofpocket medical payments actually go, two new studies have some solid clues. In one paper, Ian Larkin and colleagues at the University of California, Los Angeles, compared prescriptions written by physicians at 19 U.S. medical centers that limit the interactions with pharmaceutical sales reps with those written by physicians under no such restrictions. The analysis involved more than 25,000 physicians across the country, 262 drugs in eight major pharmaceutical categories and more than $60 billion in total sales.
According to the report, published in May in JAMA (formerly The Journal of the American Medical Association), when sales reps did not have unrestricted access to physicians—and could not offer, for example, gifts or free meals and drinks in exchange for some face time—those physicians were more likely to prescribe generic drugs than costlier, brand-name medications. Instituting rules that limited marketing calls led to an increase of up to 10 percent in physicians favoring cheaper generics over more expensive, branded drugs. That number may seem modest, but “small differences mean big differences when you consider the larger population,” says Susannah Rose, a researcher at the Cleveland Clinic who studies conflicts of interest in health care. (She was not involved with this study.)The study also showed that the change happened quickly after the medical centers instituted marketing restrictions.