Priming the pump: Biopharma contributions and prescribing patterns

All opinions are my own and do not necessarily reflect those of Novo Nordisk.

How in control are we of the decisions we make every day?  How sure are we of our judgement, how we feel, what we believe?  I think many people would say they feel very in control and very certain.  I suspect many people are wrong.  Studies in behavioral psychology have begun identifying the effect of priming–how a subtle stimulus can affect how people, behave or think.  The field of priming is not without ongoing controversy, but at the same time the effect of priming has been seen in many studies (like this one) and appears to be a real phenomenon, albeit one that is still very challenging to clearly describe, test and validate.

Its in this context that a recent report describing physician prescribing patterns is particularly interesting.  And disturbing.  The study by Joseph Engelberg, Christopher Parsons and Nathan Tefft looked at the effect of Biopharma payments to what drugs doctors prescribe.  To quote from their introduction for some context:  “While such rent-seeking behavior [such as pushing more expensive merchandise by salespeople] might not surprise many people…that financial conflicts of interest could influence their doctor’s advice might be both less expected and more worrisome…intrinsic motivation is thought to be important in medicine, with the goal of optimizing patient health being a paramount objective.”  The null hypothesis would be that prescribing patterns would be related solely to health condition, general information about drug efficacy, and price to the patient.  That’s not what was found. Continue reading