Physicians Paid Bonuses by Pharma Companies are More Likely to Prescribe Them

Bribing a physician

Pharmaceutical companies pay millions of dollars to doctors every year for various services. Most of this money goes to doctors who perform speaking engagements for pharma companies, conventions where paid doctors attempt to “inform” other doctors in attendance on the benefits of the painkillers made by the pharma companies paying the doctors to speak. And while it’s illegal for doctors to prescribe drugs in exchange for kickbacks from a manufacturer, it is not unlawful for doctors to accept private commissions from pharma companies to promote that company’s line of drugs.

“I don’t know if the money is causing the prescribing or the prescribing led to the money, but in either case, it’s potentially a vicious cycle.”

Dr. Michael Barnett, an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health, commented. “I don’t know if the money is causing the prescribing or the prescribing led to the money, but in either case, it’s potentially a vicious cycle. It’s cementing the idea for these physicians that prescribing this many opioids is creating value.”

The Critical Numbers

The Harvard findings and other research on this subject were reported on extensively in multiple media outlets. The relationship between cash payments, the dollar amount of those payments, and the number of painkillers prescribed could not be more apparent. Yet even though research has been thorough and reporting has been quite clear, this is a problem that still continues to this day.

Here’s how the numbers break down:

  • Among the doctors in the top 25 percent of the most opioids prescribed by volume, 72 percent of those doctors received payments by pharma companies.
  • Among the doctors in the top five percent of the most opioids prescribed by volume, 84 percent of those doctors received payments by pharma companies.
  • Among the doctors in the top tenth of one percent of the most opioids prescribed by volume, 95 percent of those doctors received payments by pharma companies.
  • Not only are the doctors who are prescribing the most opioids also the ones who are more likely to receive cash payments from pharma companies, but the doctors who prescribe the most drugs per year are also the ones who receive the highest amounts of money.
  • For example, the doctors who were in the top five percent of physicians who prescribed the most opiates were individuals who received twice as much money from drug manufacturers than doctors whose prescribing rate was at or around the national average.
  • The top one percent of doctors who prescribed the most opiates received four times as much money as the typical doctor.
  • Doctors in the top tenth of one percent of prescribers received nine times more money from pharma companies than the average doctor.

Open payments search tool

There exists an online tool that consumers can use to search doctors’ prescribing records to determine which doctors in their area prescribed the most opioids and which ones were compensated the most by pharma companies. And while this tool is helpful for patients in selecting a primary care provider, it does nothing to make up for the thousands of patients who have died from overdoses on painkiller drugs they might never have needed in the first place.

Deaths from Prescription Opiates – The Fatal Aspect of the Crisis

Not only is it outrageous that the doctors who receive the most money from opiate drug makers are also the doctors who prescribe the most, but this activity is likely adding to the death toll of the opiate epidemic. According to the Centers for Disease Control and Prevention, an average of 41 people died every day in 2018 for overdoses involving prescription opiates.

With about 15,000 people dying from painkiller overdoses in 2018, that number constitutes one-third of all opiate-related deaths. These deaths are entirely preventable. It’s mind-boggling that so many people would die from totally legal and, in fact, encouraged medicines made by pharmaceutical companies.

And there is yet another lethal factor to consider. Because pharma companies and the medical field have so effectively distributed addictive painkillers into the hands of the American people, clandestine drug makers have now figured out how to reproduce such drugs in their own laboratories. Case in point, illicitly-made fentanyl was responsible for more than 31,000 deaths in 2018, more than double the death toll of legal painkillers.

When doctors overprescribe painkillers (and when pharma companies make addictive painkillers in the first place), it starts a domino effect of destruction. Now, drugs like illicitly-manufactured fentanyl cause endless crisis across the nation. Would the illicit fentanyl problem ever have cropped up if pharma companies and doctors hadn’t succeeded in spreading legal fentanyl across the country in the first place?

The Centers for Disease Control and Prevention Release Guidelines for Conservative Prescribing

In an effort to halt the ongoing problem of physicians prescribing too many painkillers to patients, the Centers for Disease Control and Prevention released a document formally delineating correct prescribing methodology for high-strength painkillers. While the report contended that different patients would undoubtedly have unique needs, the underlying message throughout the document was that physicians needed to be extremely cautious and extremely conservative when prescribing painkillers.

Physician is checking information on a computer

Included below are a few of the recommendations from that document:

  • Physicians should always review prescription drug monitoring program data to determine whether their patient already has opiates from another doctor. That should be the first step, as doctors should avoid prescribing painkillers to patients who are already on painkillers prescribed by other doctors.
  • Nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred for chronic pain. If a patient can be treated for pain without resorting to opiates, they absolutely should be. Opioids should be held as a last resort for pain relief. And when painkillers are required, they should only be used in tandem with other nonpharmacologic approaches.
  • Physicians should always inform their patients of the genuine risks present in painkillers. Physicians should also form an agreement with patients that, should risks of taking painkillers outweigh the perceived benefits of taking them, that opiate prescribing be discontinued.
  • When prescribing opiates, physicians should seek to prescribe immediate-release opioids whenever possible (as opposed to extended-release drugs). Physicians should always prescribe only the lowest effective dosage for the shortest duration possible.

Now that the CDC has released prescribing guidelines, doctors should be more cautious in prescribing. The medical community cannot allow for the continuation of overprescribing.

On top of the CDC and individual doctors doing their best to reduce painkiller addiction, family members and loved ones of addicts should also do their best to help their loved ones.

What to Do if Your Loved One is Addicted to Their Meds

Do you know someone who started taking opioid painkillers for a legitimate pain problem but wound up addicted to them? Are they now self-medicating and unable to stop? While prescription painkillers are supposed to be safe for consumption, they are not chemically very different from heroin. Some painkillers are even more potent than heroin. In short, they have the potential to be very addictive.

If someone you care about cannot stop using pain meds, they must seek the help of an addiction treatment center. Drug and alcohol rehab programs possess the tools, environment, staff, detox services, and other methodologies needed to help addicts regain control of their lives. Residential treatment centers help people overcome both the physiological and psychological tripwires of addiction, effectively supplying them with the tools and strategies they need to live a healthy, sober life.

Don’t let your loved one fall further into the devastating trap that is opiate addiction. The longer you wait, the more likely it is they will never stop using drugs. Make sure your loved one gets help by contacting a treatment center today.




After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.