@article {Inoue647, author = {Kosuke Inoue and Jose F Figueroa and E John Orav and Yusuke Tsugawa}, title = {Association between industry payments for opioid products and physicians{\textquoteright} prescription of opioids: observational study with propensity-score matching}, volume = {74}, number = {8}, pages = {647--654}, year = {2020}, doi = {10.1136/jech-2020-214021}, publisher = {BMJ Publishing Group Ltd}, abstract = {Background Industry marketing to physicians for opioids has received substantial attention as it can potentially influence physicians{\textquoteright} prescription of opioids. However, robust evidence demonstrating a causal link between industry payments for opioids and physicians{\textquoteright} prescription practice for opioids is lacking.Methods Using the national databases of physicians treating Medicare beneficiaries, we examined the association between physicians{\textquoteright} receipt of opioid-related industry payments in 2016 and (1) the number of opioids prescribed and (2) the annual expenditures for the opioid products by those physicians in 2017, using propensity-score matching in a 1:1 ratio adjusting for the physician characteristics (sex, years in practice, medical school attended, specialty), the number of opioid prescriptions in 2016, and physicians{\textquoteright} financial relationships with industry in 2015. We compared matched pairs of physicians using the estimated effect and paired t-test.Results Among 43~778 physicians included after propensity-score matching, physicians who received opioid-related industry payments in 2016 prescribed more opioids (153.8 vs 129.7; adjusted difference (95\% CI), 24.1 (19.1~to~29.1)) and accounted for more spending due to opioids ($10~476 vs $6983; adjusted difference (95\% CI), $3493 (2854~to~4134)) in 2017, compared with physicians who did not receive payments. The association was larger among primary care physicians than surgeons or specialists. The dose{\textendash}response analysis revealed that even a small amount of industry payments was sufficient to effectively affect physicians{\textquoteright} prescription practice of opioids.Conclusions Opioid-related industry payments to physicians in the prior year were associated with a higher number of opioid prescriptions and expenditures for opioid products in the subsequent year.}, issn = {0143-005X}, URL = {https://jech.bmj.com/content/74/8/647}, eprint = {https://jech.bmj.com/content/74/8/647.full.pdf}, journal = {Journal of Epidemiology \& Community Health} }