Importance Reported transfers of value (TOV) from pharmaceutical companies have been associated with greater use of branded anti-vascular endothelial growth factor agents by ophthalmologists, but payment under the Medicare Part B buy-and-bill model includes a financial incentive to choose costlier agents, potentially confounding analyses of pharmaceutical TOV and prescribing patterns. How these reported TOV are associated with prescribing patterns for prescription eye drops, not subject to the incentives created by Part B payments, should be considered. Objective To assess the association between prostaglandin analog (PGA) eye drop prescribing and reported nonresearch TOV by makers of branded PGAs to US vision care professionals. Design, Setting, and Participants This retrospective cohort analysis used a 20% nationally representative sample of 2018 Medicare Part D claims and industry TOV reported to the Open Payments program. Optometrists and ophthalmologists who had more than 10 claims for PGA drops in the 20% sample were analyzed. Analysis took place from June 2021 to February 2022. Main Outcomes and Measures Multivariable logistic regression assessing the association between membership in strata of reported TOV and branded PGA prescribing rate, controlling for prescriber demographic factors, local area practices, total PGA prescribing volume, and plan formularies involved. Results A total of 20 612 ophthalmologists and 5426 optometrists (7449 [29%] female and 18 589 [71%] male) prescribed PGA eye drops. Of these, 9685 (37%) were reported to have received TOV from manufacturers of branded PGAs in 2018, totaling $5 060 346. The median (IQR) reported TOV was $65 ($24-$147). Multivariable logistic regression showed that the predicted probability of primarily prescribing branded PGAs among prescribers who reported receiving no TOV was 12.9% (95% CI, 12.4%-13.4%). This figure increased to 19.6% (95% CI, 18.8%-20.4%) among prescribers receiving TOV, a 50% increase. There was a dose-response association, such that the top 10% of TOV recipients had a 29.2% probability (95% CI, 26.4%-31.9%) of preferential branded use. Conclusions and Relevance While the median reported TOV to a PGA prescriber was relatively low in this study, there was a positive association between amount of reported nonresearch TOV received from PGA makers and the frequency of branded PGA use. This shows that small reported TOV were associated with differences in prescribing. High rates of branded PGA prescribing may pose a cost burden to patients that affects adherence. Clinicians and policy makers should be aware of these associations.

中文翻译：

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美国公开支付报告的行业价值转移与前列腺素模拟处方之间的关联。

重要性 制药公司报告的价值转移 (TOV) 与眼科医生更多地使用品牌抗血管内皮生长因子药物有关，但 Medicare B 部分购买和账单模式下的支付包括选择更昂贵药物的经济激励, 可能混淆药物 TOV 和处方模式的分析。应考虑这些报告的 TOV 如何与处方眼药水的处方模式相关联，不受 B 部分付款产生的激励措施的影响。目的 评估前列腺素类似物 (PGA) 滴眼液处方与品牌 PGA 制造商向美国视力保健专业人员报告的非研究 TOV 之间的关联。设计，设置，和参与者这项回顾性队列分析使用了 2018 年 Medicare D 部分索赔的 20% 的全国代表性样本和向公开支付计划报告的行业 TOV。分析了 20% 样本中有 10 次以上 PGA 滴剂索赔的验光师和眼科医生。分析时间为 2021 年 6 月至 2022 年 2 月。主要结果和措施多变量逻辑回归评估报告的 TOV 阶层成员与品牌 PGA 处方率之间的关联，控制处方人口统计因素、当地实践、总 PGA 处方量和计划涉及的处方集。结果 共有 20 612 名眼科医生和 5426 名验光师（7449 名 [29%] 女性和 18 589 名 [71%] 男性）开了 PGA 滴眼液。这些，据报道，2018 年有 9685 人 (37%) 从品牌 PGA 制造商那里获得了 TOV，总计 5060346 美元。报告的 TOV 中位数 (IQR) 为 65 美元（24-147 美元）。多变量逻辑回归显示，报告未接受 TOV 的处方者主要开品牌 PGA 的预测概率为 12.9%（95% CI，12.4%-13.4%）。在接受 TOV 的处方者中，这一数字增加到 19.6%（95% CI，18.8%-20.4%），增加了 50%。存在剂量反应关联，因此前 10% 的 TOV 接受者优先使用品牌产品的概率为 29.2%（95% CI，26.4%-31.9%）。结论和相关性 虽然本研究中向 PGA 处方者报告的 TOV 中位数相对较低，但从 PGA 制造商处收到的报告的非研究 TOV 数量与品牌 PGA 使用频率之间存在正相关关系。这表明小报告的 TOV 与处方差异有关。高比例的品牌 PGA 处方可能会给影响依从性的患者带来成本负担。临床医生和政策制定者应该了解这些关联。