OBJECTIVE To evaluate the association between gifts from pharmaceutical companies to French general practitioners (GPs) and their drug prescribing patterns. DESIGN Retrospective study using data from two French databases (National Health Data System, managed by the French National Health Insurance system, and Transparency in Healthcare). SETTING Primary care, France. PARTICIPANTS 41 257 GPs who in 2016 worked exclusively in the private sector and had at least five registered patients. The GPs were divided into six groups according to the monetary value of the received gifts reported by pharmaceutical, medical device, and other health related companies in the Transparency in Healthcare database. MAIN OUTCOME MEASURES The main outcome measures were the amount reimbursed by the French National Health Insurance for drug prescriptions per visit (to the practice or at home) and 11 drug prescription efficiency indicators used by the National Health Insurance to calculate the performance related financial incentives of the doctors. Doctor and patient characteristics were used as adjustment variables. The significance threshold was 0.001 for statistical analyses. RESULTS The amount reimbursed by the National Health Insurance for drug prescriptions per visit was lower in the GP group with no gifts reported in the Transparency in Healthcare database in 2016 and since its launch in 2013 (no gift group) compared with the GP groups with at least one gift in 2016 (-€5.33 (99.9% confidence interval -€6.99 to -€3.66) compared with the GP group with gifts valued at €1000 or more reported in 2016) (P<0.001). The no gift group also more frequently prescribed generic antibiotics (2.17%, 1.47% to 2.88% compared with the ≥€1000 group), antihypertensives (4.24%, 3.72% to 4.77% compared with the ≥€1000 group), and statins (12.14%, 11.03% to 13.26% compared with the ≥€1000 group) than GPs with at least one gift between 2013 and 2016 (P<0.001). The no gift group also prescribed fewer benzodiazepines for more than 12 weeks (-0.68%, -1.13% to -0.23% compared with the €240-€999 group) and vasodilators (-0.15%, -0.28% to -0.03% compared with the ≥€1000 group) than GPs with gifts valued at €240 or more reported in 2016, and more angiotensin converting enzyme (ACE) inhibitors compared with all ACE and sartan prescriptions (1.67%, 0.62% to 2.71%) compared with GPs with gifts valued at €1000 or more reported in 2016 (P<0.001). Differences were not significant for the prescription of aspirin and generic antidepressants and generic proton pump inhibitors. CONCLUSION The findings suggest that French GPs who do not receive gifts from pharmaceutical companies have better drug prescription efficiency indicators and less costly drug prescriptions than GPs who receive gifts. This observational study is susceptible to residual confounding and therefore no causal relation can be concluded. TRIAL REGISTRATION OSF register OSF.IO/8M3QR.

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2016年制药公司给法国全科医生的礼物与他们的药物处方方式之间的关联：使用“法国医疗保健透明度”和“国家卫生数据系统”数据库进行的回顾性研究。

目的评估制药公司向法国全科医生（GPs）提供的礼物与他们的药物处方方式之间的关联。设计使用来自两个法国数据库（由法国国家健康保险系统管理的国家健康数据系统和医疗保健透明度）的数据进行回顾性研究。地点法国，初级保健。参与者41257名全科医生在2016年仅在私营部门工作，并至少有5名注册患者。根据药品，医疗器械和其他与健康相关的公司在“医疗保健透明度”数据库中报告的收到的礼物的货币价值，将全科医生分为六组。主要成果指标主要成果指标是法国国家健康保险每次就诊（在家或在家）所用药物处方的报销金额，以及国家健康保险用于计算与绩效相关的财务激励措施的11种药物处方效率指标医生们。医生和患者的特征用作调整变量。统计分析的显着性阈值为0.001。结果GP组的每次就诊处方药报销金额较低，而​​2016年和2013年推出以来，``透明医疗保健''数据库中没有礼品报告（自没有礼品组），而GP组则为2016年至少一件礼物（-5.33欧元（99.9％的置信区间-6.99欧元至-3欧元。66）与GP组相比，2016年报告的礼品价值超过1000欧元（P <0.001）。无赠予组还更频繁地开出普通抗生素（与≥1000欧元组相比为2.17％，1.47％至2.88％），降压药（与≥1000欧元组相比为4.24％，3.72％至4.77％）和他汀类药物（在2013年至2016年之间，与拥有至少一份礼物的GP相比，GP-GP≥1000欧元组的比例为12.14％，11.03％至13.26％（P <0.001）。无礼品组也规定苯二氮卓类药物在12周以上的使用量要少（与€240-€999组相比，减少-0.68％，-1.13％至-0.23％）和血管扩张药（与之相比，则减少-0.15％，-0.28％至-0.03％ ≥1000欧元组的患者）比2016年报告的礼物价值240欧元或更多的GP更高，并且与所有ACE和sartan处方相比，血管紧张素转化酶（ACE）抑制剂的比例更高（1.67％，0.62％至2。71％）与2016年报告的礼物价值超过1000欧元的GP相比（P <0.001）。对于阿司匹林和通用抗抑郁药以及通用质子泵抑制剂的处方差异不大。结论研究结果表明，与接受礼物的全科医生相比，未从制药公司获得礼物的法国全科医生具有更好的药物处方效率指标和更低的药物处方费用。这项观察性研究容易受到残余混杂的影响，因此无法得出因果关系。试用注册OSF寄存器OSF.IO/8M3QR。结论研究结果表明，与接受礼物的全科医生相比，未从制药公司获得礼物的法国全科医生具有更好的药物处方效率指标和更低的药物处方费用。这项观察性研究容易受到残余混杂的影响，因此无法得出因果关系。试用注册OSF寄存器OSF.IO/8M3QR。结论研究结果表明，与接受礼物的全科医生相比，未从制药公司获得礼物的法国全科医生具有更好的药物处方效率指标和更低的药物处方费用。这项观察性研究容易受到残余混杂的影响，因此无法得出因果关系。试用注册OSF寄存器OSF.IO/8M3QR。