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Drug Diffusion Through Peer Networks: The Influence of Industry Payments

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  • Leila Agha
  • Dan Zeltzer

Abstract

Pharmaceutical companies market to physicians through individual detailing accompanied by monetary or in-kind transfers. Large compensation payments to a small number of physicians account for most of this promotional spending. Studying US promotional payments and prescriptions for anticoagulant drugs, we investigate how peer influence broadens the payments’ reach. Following a compensation payment, prescriptions for the marketed drug increase by both the paid physician and the paid physician’s peers. Payments increase prescriptions to both recommended and contraindicated patients. Over three years, marketed anticoagulant prescriptions rose 23 percent due to payments, with peer spillovers contributing a quarter of the increase.

Suggested Citation

  • Leila Agha & Dan Zeltzer, 2019. "Drug Diffusion Through Peer Networks: The Influence of Industry Payments," NBER Working Papers 26338, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:26338
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    1. Amol Navathe & Guy David, 2009. "The Formation of Peer Reputation among Physicians and Its Effect on Technology Adoption," Journal of Human Capital, University of Chicago Press, vol. 3(4), pages 289-322.
    2. Raghuram Iyengar & Christophe Van den Bulte & Thomas W. Valente, 2011. "Opinion Leadership and Social Contagion in New Product Diffusion," Marketing Science, INFORMS, vol. 30(2), pages 195-212, 03-04.
    3. Dan Zeltzer, 2020. "Gender Homophily in Referral Networks: Consequences for the Medicare Physician Earnings Gap," American Economic Journal: Applied Economics, American Economic Association, vol. 12(2), pages 169-197, April.
    4. Yann Bramoullé & Andrea Galeotti & Brian Rogers, 2016. "The Oxford Handbook of the Economics of Networks," Post-Print hal-01447842, HAL.
    5. Bramoullé, Yann & Djebbari, Habiba & Fortin, Bernard, 2009. "Identification of peer effects through social networks," Journal of Econometrics, Elsevier, vol. 150(1), pages 41-55, May.
    6. Emily Oster & Rebecca Thornton, 2012. "Determinants Of Technology Adoption: Peer Effects In Menstrual Cup Take-Up," Journal of the European Economic Association, European Economic Association, vol. 10(6), pages 1263-1293, December.
    7. Matthew Grennan & Kyle Myers & Ashley Swanson & Aaron Chatterji, 2018. "No Free Lunch? Welfare Analysis of Firms Selling Through Expert Intermediaries," NBER Working Papers 24864, National Bureau of Economic Research, Inc.
    8. Yann Bramoullé & Andrea Galeotti & Brian Rogers, 2016. "The Oxford Handbook of the Economics of Networks," Post-Print hal-03572533, HAL.
    9. Leila Agha & David Molitor, 2018. "The Local Influence of Pioneer Investigators on Technology Adoption: Evidence from New Cancer Drugs," The Review of Economics and Statistics, MIT Press, vol. 100(1), pages 29-44, March.
    10. Carey, Colleen & Lieber, Ethan M.J. & Miller, Sarah, 2021. "Drug firms’ payments and physicians’ prescribing behavior in Medicare Part D," Journal of Public Economics, Elsevier, vol. 197(C).
    11. Andrea Galeotti & Benjamin Golub & Sanjeev Goyal, 2020. "Targeting Interventions in Networks," Econometrica, Econometric Society, vol. 88(6), pages 2445-2471, November.
    12. Charles F. Manski, 1993. "Identification of Endogenous Social Effects: The Reflection Problem," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 60(3), pages 531-542.
    13. Bradley T. Shapiro, 2018. "Informational Shocks, Off-Label Prescribing, and the Effects of Physician Detailing," Management Science, INFORMS, vol. 64(12), pages 5925-5945, December.
    14. Guy David & Sara Markowitz & Seth Richards-Shubik, 2010. "The Effects of Pharmaceutical Marketing and Promotion on Adverse Drug Events and Regulation," American Economic Journal: Economic Policy, American Economic Association, vol. 2(4), pages 1-25, November.
    15. Bet Caeyers & Marcel Fafchamps, 2016. "Exclusion Bias in the Estimation of Peer Effects," NBER Working Papers 22565, National Bureau of Economic Research, Inc.
    16. Giacomo De Giorgi & Michele Pellizzari & Silvia Redaelli, 2010. "Identification of Social Interactions through Partially Overlapping Peer Groups," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 241-275, April.
    17. Berndt, Ernst R, et al, 1995. "Information, Marketing, and Pricing in the U.S. Antiulcer Drug Market," American Economic Review, American Economic Association, vol. 85(2), pages 100-105, May.
    18. David Cutler & Jonathan S. Skinner & Ariel Dora Stern & David Wennberg, 2019. "Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending," American Economic Journal: Economic Policy, American Economic Association, vol. 11(1), pages 192-221, February.
    19. Jonathan Skinner & Douglas Staiger, 2015. "Technology Diffusion and Productivity Growth in Health Care," The Review of Economics and Statistics, MIT Press, vol. 97(5), pages 951-964, December.
    20. Julie M Donohue & Hasan Guclu & Walid F Gellad & Chung-Chou H Chang & Haiden A Huskamp & Niteesh K Choudhry & Ruoxin Zhang & Wei-Hsuan Lo-Ciganic & Stefanie P Junker & Timothy Anderson & Seth Richards, 2018. "Influence of peer networks on physician adoption of new drugs," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-18, October.
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    Cited by:

    1. Raphael E Cuomo & Mingxiang Cai & Neal Shah & Tim K Mackey, 2021. "Physicians payment in the United States between 2014 and 2018: An analysis of the CMS Open Payments database," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-13, June.
    2. David M. Cutler & J. Travis Donahoe, 2024. "Thick Market Externalities and the Persistence of the Opioid Epidemic," NBER Working Papers 32055, National Bureau of Economic Research, Inc.
    3. Carey, Colleen & Lieber, Ethan M.J. & Miller, Sarah, 2021. "Drug firms’ payments and physicians’ prescribing behavior in Medicare Part D," Journal of Public Economics, Elsevier, vol. 197(C).
    4. Méndez, Susan J. & Scott, Anthony & Zhang, Yuting, 2021. "Gender differences in physician decisions to adopt new prescription drugs," Social Science & Medicine, Elsevier, vol. 277(C).
    5. Sofia Amaral-Garcia, 2020. "Medical Device Companies and Doctors: Do their Interactions Affect Medical Treatments ?," Working Papers ECARES 2020-18, ULB -- Universite Libre de Bruxelles.
    6. Ronja Flemming & Franziska Frölich & Norbert Donner‐Banzhoff & Leonie Sundmacher, 2023. "Diffusion of a new drug among ambulatory physicians—The impact of patient pathways," Health Economics, John Wiley & Sons, Ltd., vol. 32(4), pages 970-982, April.
    7. Lawler, Emily C. & Skira, Meghan M., 2022. "Information shocks and pharmaceutical firms’ marketing efforts: Evidence from the Chantix black box warning removal," Journal of Health Economics, Elsevier, vol. 81(C).
    8. Avdic, Daniel & Blankart, Katharina, 2021. "A Hard Look at “Soft” Cost‐control Measures in Healthcare Organizations: Evidence from Preferred Drug Policies in Germany," CINCH Working Paper Series (since 2020) 74978, Duisburg-Essen University Library, DuEPublico.
    9. Amaral-Garcia, S.;, 2022. "Medical Device Companies and Doctors: Do their interactions affect medical treatments?," Health, Econometrics and Data Group (HEDG) Working Papers 22/10, HEDG, c/o Department of Economics, University of York.
    10. Joshua L. Krieger & Xuelin Li & Richard T. Thakor, 2022. "Find and Replace: R&D Investment Following the Erosion of Existing Products," Management Science, INFORMS, vol. 68(9), pages 6552-6571, September.
    11. Avdic, Daniel & Blankart, Katharina, 2021. "A Hard Look at “Soft” Cost‐control Measures in Healthcare Organizations: Evidence from Preferred Drug Policies in Germany," CINCH Working Paper Series (since 2020) 74978, Duisburg-Essen University Library, DuEPublico.
    12. Sebastian Calónico & Rafael Di Tella & Juan Cruz Lopez del Valle, 2023. "The Political Economy of a “Miracle Cure”: The Case of Nebulized Ibuprofen and its Diffusion in Argentina," NBER Working Papers 31781, National Bureau of Economic Research, Inc.
    13. Agostina Brinatti & Xing Guo, 2023. "Third-Country Effects of U.S. Immigration Policy," Staff Working Papers 23-60, Bank of Canada.
    14. Melissa Newham & Marica Valente, 2022. "The Cost of Influence: How Gifts to Physicians Shape Prescriptions and Drug Costs," Papers 2203.01778, arXiv.org, revised Apr 2023.
    15. Kelli Marquardt & Conor Ryan, 2023. "The Role of Information in Pharmaceutical Advertising: Theory and Evidence," Working Paper Series WP 2023-40, Federal Reserve Bank of Chicago.
    16. Gruber, Jonathan & Lin, Mengyun & Yi, Junjian, 2023. "The largest insurance program in history: Saving one million lives per year in China," Journal of Public Economics, Elsevier, vol. 226(C).

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

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