{"doi":"10.1111/liv.16111","title":"Pharmaceutical industry payments and prescriptions of direct acting antiviral drugs for hepatitis C virus infection","abstract":"Hepatitis C virus (HCV) is a serious viral infection causing chronic HCV infection. Chronic HCV infection is the leading cause of hepatocellular carcinoma and liver transplantation in the United States (US).1 In 2020, over 100 000 new cases of HCV and approximately 15 000 HCV-related deaths were reported in the US.2 The treatment landscape for HCV has dramatically improved since the first direct-acting antiviral (DAA) was approved in 2011, achieving an eradication response rate exceeding 95%.3 However, the expensive cost of DAA treatment imposes a substantial financial burden on the US healthcare spending and patients. The recent introduction of several newer, less expensive DAAs has resulted in heightened competition among pharmaceutical companies and increased marketing activities of DAAs to physicians including HCV guideline authors.4, 5 Considering the competitive nature of the DAA market and findings from previous studies showing that the marketing payments to physicians are associated with increased prescriptions, we hypothesized that physician prescription patterns for DAAs would be associated with the payments from the pharmaceutical companies. Nevertheless, the associations of industry payments with physician DAA prescription practices had not been investigated. This analysis used data from three publicly accessible databases: the Centers for Medicare & Medicaid Services Medicare Part D, the Open Payments, and the Physician Compare databases. We focused on four DAAs currently recommended for initial HCV treatment in the US3: ledipasvir/sofosbuvir (Harvoni from Gilead Sciences, approved in October 2014), elbasvir/grazoprevir (Zepatier from Merck, approved in January 2016), sofosbuvir/velpatasvir (Epclusa from Gilead Sciences, approved in June 2016), and glecaprevir/pibrentasvir (Mavyret from AbbVie, approved in August 2017). Physician demographic characteristics were extracted from the Physician Compare database. The publicly accessible Medicare Part D database contains physician identifiers reporting more than 10 claims of a drug in a single year to protect patients' privacy. To encompass physicians who could prescribe DAAs, we extracted data on the 30-day standardized number of claims (including refills), Medicare spending, and total number of supply days associated with each DAA reported by physician prescribers from the Medicare Part D database for the years 2014 to 2021. General payments related to the four DAAs were collected from the Open Payments Database for the same period. This study included only physician prescribers, as the Open Payments Database covered payments to physicians only. The Mount Sinai institutional review board exempted this study from formal review, since this study only collected data from publicly available information and met the definition of non-human participant research. Associations between the receipt of payments associated with each DAA and the prescription of respective DAAs following each DAA's approval were evaluated using a multivariable logistic generalized estimating equation (GEE) model, adjusting for covariates at the individual physician-year level. Covariates included gender, primary specialty, years in practice, hospital affiliation, practice region, regional healthcare spending, and payment/claim year, as conducted in previous studies.6-8 Additionally, we evaluated associations between the annual number of payments and the total annual number of claims (30-day standardized, including refills) and Medicare spending using a multivariable linear GEE model, adjusting for the same covariates. Payments were considered relevant if a physician received them from a company in the year the drug was prescribed, as conducted in previous research.7, 9 As there were no claims and payments for elbasvir/grazoprevir in 2021, we examined the associations for elbasvir/grazoprevir between 2016 and 2020. In the sensitivity analyses, we also explored the associations between payments made o","journal":"Liver International","year":2024,"id":460121,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9608,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":104268,"name":"Keith Sigel","orcid":"0000-0002-4051-4861","position":1,"is_corresponding":false},{"id":439065,"name":"Elizabeth S. Tarras","orcid":null,"position":2,"is_corresponding":false},{"id":329265,"name":"Deborah Marshall","orcid":"0000-0002-6675-7482","position":3,"is_corresponding":false},{"id":1085028,"name":"Anju Murayama","orcid":"0000-0002-4279-4748","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-19T02:04:03.568045Z","pmid":"39310996","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}