Drug Money Shifts Cancer Treatment Choices

Researchers looked at Medicare claims from 2014 to 2020. They picked people who got a new cancer diagnosis during those years. The goal was to see if money from drug companies to oncologists changes which treatment patients receive.

To decide what counts as the preferred treatment, the team used the NCCN guidelines. They marked the treatment that the guidelines favor for each cancer type at the time of diagnosis. Then they grouped doctors by the payments they got in the year before the patient's diagnosis: no money, money only for the preferred treatment, money only for a non‑preferred treatment, or money for both.

The study covered 14 cancer scenarios and 15,607 patients. About 60 percent of patients saw oncologists who took no industry money. Roughly 22 percent saw doctors paid only for the preferred treatment. About 31 percent saw doctors paid only for a non‑preferred treatment. And 13 percent saw doctors who received both kinds of payments. When the oncologist had no payments, 42 percent of patients got the preferred treatment. With payments only for the preferred treatment, that share rose to 52 percent. With payments only for a non‑preferred treatment, it fell to 35 percent. With both payment types, it was 43 percent.

After adjusting for other factors, getting money for the preferred treatment made it more likely that patients received that treatment (risk ratio 1.06, confidence interval 1.01 to 1.13). Getting money for a non‑preferred treatment made it less likely (risk ratio 0.93, confidence interval 0.89 to 0.98). The bigger the payment, the stronger the effect. Industry payments push doctors toward the treatment they are paid for, even when that treatment is not the guideline‑preferred one.