Maybe Pharmaceutical Reps Actually Aren't Bribing Doctors

Is your doctor willing to sell you out for the price of a sandwich? That’s the implication a lot of people seem to have taken from a new study published by JAMA Internal Medicine. It looked at the prescribing behavior of physicians for whom pharmaceutical reps bought meals, and found that those who got even a meal worth less than $20 -- think Olive Garden or Potbelly, not Le Bernardin -- were significantly more likely to prescribe brand-name medications that had a cheaper alternative.

I’m a little less sure what to make of the study. For one thing, its design doesn’t really control for reverse causation -- the possibility that pharma reps were buying sandwiches for the folks who already prescribed their drugs more, because those folks were more interested in attending industry-sponsored events on that drug. We should also question the assumptions that the doctors who weren’t bought sandwiches are prescribing the “right” amount of these drugs, and that any deviation from this prescribing behavior represents an unjustified bias.