Prescribing Patterns and Industry Payments for Top 50 Drugs

This analysis-ready data set includes information on health care providers who prescribed any of the top 50 most-prescribed or top 50 most-costly brand-name drugs in Medicare’s prescription drug program, known as Medicare Part D, in 2016. ProPublica linked this prescribing data with information on industry payments to doctors under the Open Payments program to generate more than 2.6 million doctor-drug combinations.

Each doctor-drug combination includes the provider’s NPI number and speciality, the drug name, whether it is a top 50 drug by prescribing volume or price, the number and value of Medicare Part D claims made for each drug, the total number and value of industry payments received (by type), and total claims filled by each provider’s patients for all drugs under Medicare Part D.

ProPublica’s analysis found that for almost all of the 50 most-prescribed brand-name drugs in Medicare’s prescription drug program in 2016, physicians who had an interaction with the manufacturer involving that drug prescribed the drug at higher rates than physicians who did not. We also found that among providers who had such interactions, the dollar value of those interactions was larger for physicians who prescribed the drug than for those who did not. (As an additional sensitivity check, we conducted the same analysis looking at the 50 most-costly brand-name drugs in Medicare’s prescription drug program.)

With the available observational data we are not able to say whether payments lead to prescribing that is counter to patients’ interests, but our analysis provides new insight into the dynamics between doctors’ industry interactions and their prescribing.

Code behind our analysis is available on Github.

For each drug, health care providers are included in the dataset if they appeared in Open Payments in relation to the drug and/or if there were 11 or more claims for the drug from the provider under Medicare Part D. (The Part D data released from CMS redacts prescribers with fewer than 11 claims for a drug.)

Open Payments data from ‘general payments’ are included. Research payments and ownership interests are excluded.

Providers whose NPI could not be determined are not included in the data, nor are providers such as nurse practitioners, who are not covered by Open Payments.


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Dollars for Docs, Prescriber Checkup, and Industry Payments and Provider Prescribing Patterns

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