Joy Eckert
The George Washington University
Joy Eckert is pursuing a Master’s in Public Health with a concentration in Epidemiology at the George Washington University Milken Institute School of Public Health. She works in full-time research at GWU in the Department of Health Policy and Management. She works on research related to pharmaceutical marketing and its impact on health care. Joy is also the Project Manager for the DC Center for Rational Prescribing (DCRx) which provides evidence-based and industry-free continuing education
Background: Growth in pharmaceutical treatment costs for diabetes has outpaced growth in prevalence of diabetes. Newer drug classes, such as GLP-1 analogues and SGLT-2 inhibitors, are expensive and not proven to be more effective than metformin.[1] Pharmaceutical marketing is used to promote newer, often more expensive drugs. Previous studies have linked acceptance of gifts and meals from pharmaceutical companies with increased cost of prescriptions.[2] We investigated how cost of diabetes treatment was affected by marketing practices in the District of Columbia.
Methods: The AccessRx program in DC requires pharmaceutical companies to report gifts given to healthcare providers, drug advertising expenses, and the salaries for staff engaged in promotional activities (“detailing expenses”). We combined data from AccessRx and the federal Open Payments system to estimate promotional payments. We used Medicaid data to examine spending for diabetes treatment.
Results: In 2014, we estimated that ten companies spent $3.8 million in detailing expenses to market diabetes drugs. SGLT-2 inhibitors and GLP-1 analogues had the highest estimated detailing expenses, each totaling more than $1.2 million. From 2014 to 2015, DC Medicaid spending for Victoza (liraglutide), a GLP-1 analogue, increased 51% (from $183,873 to $362,230) and Invokana (canaglifozin), a SGLT-2 inhibitor, increased 213% (from $8,933 to $27,958).
Conclusions: Pharmaceutical promotion drives unnecessary use of newer, more expensive medications. The District of Columbia should provide education on rational prescribing for diabetes treatment (including diet and exercise).
[1] Prescrire International. Hypoglycaemic therapy in type 2 diabetics. Prescrire Int. 2015 Apr;24(159):103- 106.
Prescrire International. Glucose-lowering treatment of type 2 diabetics. Prescrire Int. 2015 May;23(160):130-135.
[2] Perlis RH, Perlis CS. Physician payments from industry are associated with greater Medicare Part D prescribing costs. PLoS One. 2016;11(5):e0155474.
DeJong C, Aguilar T, Tseng CW, et al. Pharmaceutical industry-sponsored meals and physician prescribing patterns for Medicare beneficiaries. JAMA Intern Med. 2016;176(8):1114-10.
Prevalence and drivers of overuse , Harms of overuse (physical, psychological or system-related) , Areas of concurrent underuse and overuse
