Drug companies buy loyalty through showering doctors with gifts, a new study shows. And it may take only a single meal on their tab to have a greater chance of a doctor penning a prescription for the branded drug.

The new research by a team from University of California, San Francisco, found that the more meals or the more expensive they are, the greater the rate of prescribing the proposed drug. But modesty may not necessarily be a hindrance: the meals received had an average cost of less than $20.

“The relationship was dose dependent, with additional meals and costlier meals associated with greater increases in prescribing of the promoted drug," wrote the team led by Dr. R. Adams Dudley, looking at prescribing data for four popular medications from almost 280,000 Medicare doctors.

The drugs in the study were cholesterol drug rosuvastatin (Crestor), blood pressure drugs nebivolol (Bystolic) and olmesartan medocomil (Benicar) and antidepressant desvenlafaxine (Pristiq).

Earlier complaints on these efforts by drug companies escalated in 2008 that the industry voluntarily gave up plenty of freebies offered to physicians, from their logo-carrying pens to expensive equipment.

Big medical conferences also became notably sparse on gifts and promotional items such as branded luggage, electronic devices and medical supplies, reported NBC News.

The subjects received some form of benefits – almost all meals – worth $20 or less. Even a single meal when the drug was discussed translated to higher prescribing activities.

Those who obtained at least four meals relating to the pitched drugs prescribed the drugs more often, such as Crestor at twice the rate of doctors who did not get free meals. Bystolic was prescribed more than five times as often, Benicar more than four times and Pristiq three times more.

The study was deemed an improvement over previous research as it narrowly analyzed doctors who got meals promoting a particular drug and their prescribing behavior. It, however, does not prove causation but instead established an association.

“The consequences are this is distorting health-care spending in a way that is large and necessary,” medicine professor Jerry Avorn, who was not involved in the study, told the Washington Post.

Avorn explained that while there has been a movement away from extravagant and “frankly embarrassing” gifts of massive value, it remains problematic that doctors learn about drugs by virtue of free meals.

In an email to the Post, Holly Campbell, industry trade group PhRMA spokesperson, said the study “cherry-picks” doctor-prescribing information to present a wrong picture. She said that drug manufacturers regularly engage with doctors to discuss drug safety and efficacy as well as new indications and potential adverse effects.

The findings were detailed in the journal JAMA Internal Medicine.

Photo: Phalinn Ooi | Flickr