Date of Award

January 2019

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Saral Mehra

Abstract

Physician-industry interactions are common, and the nature of industry payment to physicians and the subsequent conflicts of interest it may cause have come under increased scrutiny. In this study, we sought to associate industry compensation to otolaryngologists and other physicians with brand-name prescribing patterns. We linked the Open Payments Database, which details all industry payments to physicians, with the Medicare Part D Participant User File, which records all prescriptions written at a physician’s discretion to Medicare Part D participants. We associated the receipt of industry funding by otolaryngologists within a hospital referral region (HRR) with the percentage of brand name prescriptions written by otolaryngologists within that HRR. This was repeated at the level of the individual physician. We then associated receipt of industry compensation for brand-name nasal steroids and proton pump inhibitors with preferential prescription of the respective brand-name drugs. We found that otolaryngologists practicing in hospital referral regions with more industry payments to otolaryngologists prescribed a higher proportion of brand-name drugs. We found that the number and dollar value of industry payments to individual physicians was also linked to the percentage of brand-name drugs. For both nasal steroids and proton pump inhibitors, physicians receiving industry payments for brand-name drugs were more likely to prescribe the respective drug, and both the number and dollar value of payments was associated with an increased rate of prescribing that brand-name drug. In conclusion, we found that industry payments are associated with prescribing patterns in otolaryngologists and in other physicians treating otolaryngology-related conditions.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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