Impact of the Affordable Care Act's physician payments sunshine act on branded statin prescribing Journal Article


Authors: Li, J.; Wu, B.; Flory, J.; Jung, J.
Article Title: Impact of the Affordable Care Act's physician payments sunshine act on branded statin prescribing
Abstract: Objective: To evaluate the impact of the Affordable Care Act's Physician Payments Sunshine Act (PPSA), which mandates disclosure of industry payments to physicians, on physician prescribing of branded statins. Data Sources: Administrative claims data from 2011 to 2015 from three large national commercial insurers were provided by the Health Care Cost Institute. Study Design: We adopted a difference-in-differences and event study design, leveraging the control group of physicians in two states, MA and VT, which implemented state laws on disclosure of industry payments prior to the national PPSA. To further address potential confounding caused by differences in prescribing patterns across states, our analytical sample includes physicians practicing in border counties between the treatment (NH, NY, and RI) and control (MA and VT) states. Data Collection: We restricted our sample to physicians who had at least 50 new-fill prescription claims for statins during the five-year study period, with at least one new-fill prescription claim each year. Principal Findings: We found that the PPSA led to a 7% (p < 0.001) reduction in monthly new prescriptions of brand-name statin over the study period, with little change in generic prescribing. The reduction in branded prescriptions was concentrated among physicians with the highest tercile of drug spending pre-PPSA, with a decrease of 15% (p < 0.001) in new branded statin prescriptions. The decline was most prominent after mandated reporting of industry payments began before the payment data was published. Conclusions: The PPSA may have achieved its intended effect of reducing branded prescriptions at least in the short run, particularly among physicians most likely to have engaged in excessive or low-value prescribing of branded drugs. © 2022 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust.
Keywords: controlled study; aged; major clinical study; united states; health care policy; health care cost; medicare; prescription; physicians; physician; interpersonal communication; hydroxymethylglutaryl coenzyme a reductase inhibitor; medical fee; drug industry; prescribing; disclosure; study design; hydroxymethylglutaryl-coa reductase inhibitors; drug; generic drug; rosuvastatin; patient protection and affordable care act; affordable care act; humans; human; male; female; article; administrative claims (health care); sunshine act; medicare part d; industry payment; prescribing practice; ezetimibe plus simvastatin; lovastatin plus nicotinic acid; pitavastatin; health legislation
Journal Title: Health Services Research
Volume: 57
Issue: 5
ISSN: 0017-9124
Publisher: Health Research and Educational Trust  
Date Published: 2022-10-01
Start Page: 1145
End Page: 1153
Language: English
DOI: 10.1111/1475-6773.14024
PUBMED: 35808991
PROVIDER: scopus
PMCID: PMC9441271
DOI/URL:
Notes: Article -- Export Date: 3 October 2022 -- Source: Scopus
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  1. James H Flory
    69 Flory