Tuesday, June 21, 2016

Pharmaceutical Industry Practice Of Cheap Free Meals to Doctors Increases Prescriptions For Higher Priced Branded Drugs Over Generics

From Bloomberg, "Doctors Getting Free Meals Pick Branded Drugs More, Study Finds" by Jared S Hopkins:
Doctors who accept free meals from the pharmaceutical industry are more likely to prescribe certain branded drugs to Medicare patients than generics, according to a study published Monday.

The article in JAMA Internal Medicine documents a group of almost 280,000 doctors who received industry-sponsored meals, typically costing less than $20, in 2013. The study found that the doctors more frequently prescribed the four most common brand-name drugs that were available in the Medicare Part D program. In the case of Bystolic, a beta blocker for high blood pressure, physicians who received at least four meals chose the brand 5.4 times as often as generics.

"What was most surprising to me was that such small payments were associated with big differences in physician prescriptions," said Colette Dejong, one of the study’s authors and a research fellow at the Center for Healthcare Value at the University of California at San Francisco. "It was previously thought it takes a certain amount of money to influence a doctor, and the current guidelines are written that way."
What a surprise. Doctors are human after all and behave just like everyone else. Their decisions are not always objective or the best and can be manipulated.

The US Upper Middle Class Is Larger: Expanding From 12% In 1979 To Nearly 30% In 2014

From The Wall Street Journal, Real Time Economics, "Not Just the 1%: The Upper Middle Class Is Larger and Richer Than Ever: Research shows the number of upper middle class households has more than doubled since 1979" by Josh Zumbrun:
A range of data after the recession and the housing bust supported the idea that only a tiny elite of U.S. society, generally seen as the top 1%, had rebounded and was doing well.

But a growing body of evidence suggests the economic expansion since the 2007-2009 financial crisis has enriched a much larger swath of the upper middle class, and that a deeper income divide is developing between that top quarter or so of the population and everyone else.

The latest piece of evidence comes from economist Stephen Rose of the Urban Institute, who finds in new research that the upper middle class in the U.S. is larger and richer than it’s ever been. He finds the upper middle class has expanded from about 12% of the population in 1979 to a new record of nearly 30% as of 2014.
From the abstract to the "The Growing Size and Incomes of the Upper Middle Class" by Stephen Rose:
This report uses absolute income thresholds adjusted for inflation and family size to show that the size of the upper middle class grew from 12.9 percent of the population in 1979 to 29.4 percent in 2014. In terms of shares of total income, the middle class controlled a bit more than 46 percent of all incomes in 1979, while the upper middle class and rich controlled 30 percent. By 2014, the rich and upper middle class controlled 63 percent of all incomes, while the middle class share had shrunk to 26 percent.