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1 Supplementry Online Content DeJong C, Aguilr T, Tseng CW, Lin GA, Boscrdin WJ, Dudley RA. Phrmceuticl industry sponsored mels nd physicin prescriing ptterns for Medicre eneficiries. JAMA Intern Med. Pulished online June 20, doi: /jminternmed etle 1. Medictions in the Four Trget Drug Ctegories efigure. Study Flow Digrm etle 2. Chrcteristics of Physicins in the Study Popultion etle 3. Predictors of Trget-Drug Prescriing, Adjusted for Averge Cost per Mel etle 4. Propensity Score Decile-Adjusted Odds Rtios for Prescriing the Trget Drug etle 5. Results of Flsifiction Test: The Effect of Rosuvsttin Mels on Desvenlfxine Prescriing, nd the Effect of Desvenlfxine Mels on Rosuvsttin Prescriing etle 6. Predictors of Trget Drug Prescriing, with Low-Volume Prescriers Excluded etle 7. Predictors of Trget Drug Prescriing, with Clim Count Stndrdized to 30-Dy Supplies etle 8. Predictors of Rosuvsttin Prescriing s Percentge of High-Intensity Sttin Prescriptions This supplementry mteril hs een provided y the uthors to give reders dditionl informtion out their work Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

2 etle 1. Medictions in the Four Trget Drug Ctegories Sttins Crdioselective ACE inhiitors nd ARBs SSRIs nd SNRIs Β-Blockers ACE inhiitors ARBs SSRIs SNRIs Crestor (Rosuvsttin) Bystolic (Neivolol) Benzepril HCL Benicr (Olmesrtn) Citloprm HBR Pristiq ER (Desvenlfxine succ.) Livlo Atenolol Lotensin Diovn (Vlsrtn) Celex (Citloprm) Desvenlfxine se (Pitvsttin) (Benzepril) Atorvsttin Tenormin Cptopril Edri (Azilsrtn) Escitloprm oxlte Khedezl Clcium (Atenolol) (Desvenlfxine se) Lipitor (Atorvsttin) Betxolol HCL Cpoten (Cptopril) Cndesrtn cilexetil Lexpro (Escitloprm) Duloxetine HCL Simvsttin Kerlone (Betxolol) Enlpril mlete Atcnd (Cndesrtn) Fluoxetine DR Cymlt (Duloxetine) Zocor (Simvsttin) Bisoprolol fumrte Vsotec (Enlpril) Eprosrtn Fluoxetine HCL Venlfxine HCL Fluvsttin Sodium Zeet (Bisoprolol) Fosinopril Sodium Teveten (Eprosrtn) Prozc (Fluoxetine) Effexor (Venlfxine) Lescol (Fluvsttin) Metoprolol trtrte Monopril (Fosinopril) Iresrtn Prozc Weekly (Fluoxetine) Effexor XR (Venlfxine) Lescol XL (Fluvsttin) Lopressor (Metop. trtrte) Lisinopril Avpro (Iresrtn) Proxetine HCL Fetzim (Levomilnciprn) Lovsttin Metoprolol succinte Prinivil (Lisinopril) Losrtn potssium Pxil (Proxetine) Altoprev (Lovsttin) Toprol XL (Metop. succinte) Zestril (Lisinopril) Cozr (Losrtn) Pxil CR (Proxetine) Mevcor (Lovsttin) Moexipril HCL Micrdis (Telmisrtn) Pexev (Proxetine) Prvsttin Sodium Univsc (Moexipril) Sertrline HCL Prvchol Perindopril erumine Zoloft (Sertrline) (Prvsttin) Aceon (Perindopril) Quinpril HCL Accupril (Quinpril) Rmipril Altce (Rmipril) Trndolpril Mvik (Trndolpril) Epned (Enlpril) Medictions excluded from the four trget drug ctegories - Breviloc (Esmolol) c Enlprilt (Enlpril) c - Srfem (Fluoxetine) d Vsotec IV Brisdelle (Enlpril) c (Proxetine) d Irenk (Duloxetine) e Desvenlfxine fumrte e Inhice (Cilzpril) g Brintellix (Vortioxetine) f Svell (Milnciprn) d Viiryd (Vilzodone) f Drugs were identified using Lexi-Drugs (Lexicomp) Phrmcologic Ctegories. We included ll formultions nd excluded comintion pills. ACE denotes ngiotensin-converting enzyme, ARB ngiotensin-receptor locker, SNRI serotonin-norepinephrine reuptke inhiitor, nd SSRI selective serotonin-reuptke inhiitor. Denotes generic mediction c Not ville orlly d Not FDA-pproved for the trget drug ctegory s primry indiction (depression [SSRIs nd SNRIs], hyperlipidemi [sttins], nd hypertension [ACE inhiitors, ARBs, nd β-lockers]). e FDA-pproved fter f Excluded for mjor phrmcologic difference: in ddition to cting s selective serotonin reuptke inhiitor, vortioxetine (Brintellix ) is 5-HT 1A nd 5- HT 3 receptor gonist nd vilzodone (Viiryd ) is 5-HT 1A receptor prtil gonist. g Not ville in the U.S Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

3 efigure. Study Flow Digrm 533,919 physicins identified in the Medicre Prt D Prescrier dtset 279,669 physicins in the study popultion 254,250 were excluded from the study popultion - 189,278 hd rnded clim count redcted y CMS - 63,562 did not mtch with Physicin Compre - 1,232 hd identicl mtching criteri excluded for medicl school grdution yer post-2013 or pre-1910 (presumed inccurcy) 155,849 physicins met inclusion criteri for t lest one of four study groups: 131,207 wrote more thn 20 filled sttin prescriptions 126,134 wrote more thn 20 filled crdioselective β- locker prescriptions 131,343 wrote more thn 20 filled ACE inhiitor or ARB prescriptions 123,318 wrote more thn 20 filled SSRI or SNRI prescriptions 19,619 were excluded from the regression smple - 11,382 received untgged or non-mel trget pyments - 4,360 missing Med. HH Inc. - 1,957 missing Pop. Density - 3 missing Census Region -1,577 missing MA-PD count missing LIS count 9,778 were excluded from the regression smple - 1,952 received untgged or non-mel trget pyments - 4,226 missing Med. HH Inc. - 1,888 missing Pop. Density - 2 missing Census Region - 1,477 missing MA-PD count missing LIS count 10,024 were excluded from the regression smple - 1,529 received untgged or non-mel trget pyments - 4,514 missing Med. HH Inc. - 2,018 missing Pop. Density - 3 missing Census Region - 1,614 missing MA-PD count missing LIS count 9,334 were excluded from the regression smple - 1,884 received untgged or non-mel trget pyments - 3,843 missing Med. HH Inc. - 1,543 missing Pop. Density - 3 missing Census Region - 1,599 missing MA-PD count missing LIS count 111,588 sttin prescriers included in the regression nlysis 116,356 β-locker prescriers included in the regression nlysis 121,319 ACE inhiitor nd ARB prescriers included in the regression nlysis 113,984 SSRI nd SNRI prescrie included in the regression nlysis Med. HH Inc. refers to medin household income; Pop. Density refers to urn or rurl sttus; MA-PD Count refers to proportion of totl prescriptions written for Medicre Advntge Prt D eneficiries; nd LIS Count refers to the proportion of totl prescriptions written for low-income susidy eneficiries. These physicins resided outside of ny U.S. Census Region (e.g. in Puerto Rico) Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

4 etle 2. Chrcteristics of Physicins in the Study Popultion (N = 279,669) Demogrphic chrcteristics Physicins receiving no pyments (N=134,865) Physicins receiving pyments (N=144,804) P-vlue c Gender <0.001 Mle (%) Femle (%) Specilty (%) <0.001 Internl medicine Fmily medicine nd generl prctice Crdiology 4 6 Psychitry 6 5 Other Group prctice size (%) < Yers since medicl school grdution (%) < U.S. geogrphic region (%) <0.001 Northest Midwest South Pcific West Mountin West 6 6 Urn (%) <0.001 Difference (95% CI) d Medin household income in ZIP Code 44.7 ± ± (-0.54, -0.25) ($1,000) % clims for LIS eneficiries 43.0 ± ± (2.85, 3.23) % clims for MA-PD eneficiries 33.1 ± ± (2.80, 3.15) Proportion of ll 2013 clims (in ny drug (-2.42, -2.20) clss) written for rnded drugs (%) Plus-minus vlues re mens +/-SD. ACE denotes ngiotensin-converting enzyme, ARB ngiotensin-receptor locker, SSRI selective serotonin-reuptke inhiitor, nd SNRI serotonin-norepinephrine reuptke inhiitor. LIS refers to low-income susidy nd MA-PD refers to Medicre Advntge Prt D. Percentges do not dd up to 100% due to missing oservtions. Pyments refer to those conducted etween August 1, 2013 nd Decemer 31 st, 2013 in the Generl ctegory of the Open Pyments dtset, excluding reserch-relted or proprietry pyments. c Reported p-vlues re the result of chi-squre tests of the ssocition etween the ctegoricl vrile nd receipt of ny form of industry pyment. d For continuous vriles, 2-smple t-tests were conducted to test the difference in mens etween physicins who did nd did not receive ny form of industry pyment Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

5 etle 3. Predictors of Trget Drug Prescriing, Adjusted for Averge Cost per Mel Vrile Rosuvsttin (N = 9,066) Neivolol Olmesrtn (N = 2,066) (N = 7,811) Adjusted Odds Rtios (95% CI) Desvenlfxine (N = 1,644) Dys receiving trget drugsponsored mels (1.02, 1.03) 1.18 (1.16, 1.20) 1.18 (1.17, 1.19) 1.06 (1.01, 1.11) (1.06, 1.07) 1.30 (1.26, 1.33) 1.31 (1.29, 1.33) 1.50 (1.40, 1.59) (1.13, 1.15) 1.45 (1.40, 1.50) 1.50 (1.49, 1.52) 1.32 (1.23, 1.42) Averge cost per mel pyment < $20 $ (1.12, 1.13) 1.11 (1.07, 1.15) 1.02 (1.01, 1.03) 1.05 (0.91, 1.22) Mle Femle 1.05 (1.04, 1.06) 0.93 (0.91, 0.94) 1.01 (1.00, 1.02) 0.76 (0.73, 0.80) Totl volume of clims within the drug clss 1.00 (1.00, 1.00) 0.98 (0.98, 0.98) 1.01 (1.01, 1.01) 0.98 (0.98, 0.99) Specilty Internl Medicine Fmily Medicine nd Generl Prctice 1.03 (1.03, 1.04) 0.99 (0.97, 1.00) 0.91 (0.90, 0.91) 1.04 (1.00, 1.08) Crdiology 1.45 (1.44, 1.46) 1.27 (1.24, 1.29) 0.94 (0.92, 0.96) - Psychitry (2.21, 4.04) Other 1.12 (1.10, 1.13) 1.21 (1.16, 1.27) 0.86 (0.84, 0.89) 1.64 (1.50, 1.80) Numer of memers in group prctice (0.90, 0.91) 0.88 (0.86, 0.89) 0.85 (0.84, 0.86) 0.80 (0.76, 0.84) (0.88, 0.89) 0.93 (0.91, 0.95) 0.86 (0.85, 0.88) 0.97 (0.91, 1.03) (0.87, 0.88) 0.82 (0.80, 0.84) 0.85 (0.84, 0.86) 0.80 (0.76, 0.84) % of prescriptions for rnded drugs < 25 th percentile 0.65 (0.65, 0.66) 0.51 (0.49, 0.52) 0.58 (0.57, 0.60) 0.79 (0.72, 0.86) Within 25 th -75 th percentile 75 th percentile 1.68 (1.67, 1.69) 2.25 (1.91, 2.68) 1.79 (1.78, 1.81) 1.96 (1.88, 2.04) Yers since grdution from med school (1.06, 1.13) 2.25 (1.91, 2.68) 1.10 (1.02, 1.20) 0.99 (0.75, 1.35) (1.09, 1.16) 2.24 (1.90, 2.66) 1.17 (1.09, 1.27) 1.12 (0.84, 1.52) Geogrphic region Northest Midwest 0.93 (0.92, 0.94) 1.48 (1.45, 1.52) 0.73 (0.72, 0.75) 1.52 (1.41, 1.64) South 1.12 (1.11, 1.13) 1.56 (1.53, 1.59) 0.80 (0.80, 0.81) 1.45 (1.35, 1.55) Pcific West 0.79 (0.78, 0.80) 1.38 (1.34, 1.41) 1.11 (1.09, 1.12) 1.95 (1.77, 2.15) Mountin West 0.92 (0.91, 0.93) 1.98 (1.92, 2.05) 0.87 (0.84, 0.89) 0.80 (0.70, 0.91) Popultion Density Rurl Urn 1.09 (1.08, 1.10) 0.96 (0.94, 0.97) 1.27 (1.25, 1.29) 0.99 (0.94, 1.04) Medin Household income in ZIP c Code 0.97 (0.96, 0.97) 0.98 (0.97, 0.98) 0.97 (0.97, 0.98) 0.95 (0.93, 0.97) % Clims for LIS eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 1.01 (1.00, 1.01) % Clims for MA-PD eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) This multivrile logistic regression nlysis ws restricted to physicins who received t lest one trget mel, nd djusted for verge cost per mel received (<$20 or $20). Prescription volume ws divided y 100 to produce more meningful odds rtios. c Medin Household Income in ZIP Code ws converted to Z-Score Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

6 etle 4. Propensity Score Decile-Adjusted Odds Rtios for Prescriing the Trget Drug Vrile Rosuvsttin (N = 111,587) Neivolol (N = 116,355) Olmesrtn (N = 121,318) Desvenlfxine (N = 113,983) Did not receive trget mels Received trget mels 1.19 (1.19, 1.20) 1.79 (1.78, 1.80) 1.74 (1.73, 1.75) 2.30 (2.25, 2.34) Propensity scores were clculted using logistic regression predicting receipt of trget mels. In ddition to propensity score decile, odds rtios were djusted for ll covrites included in the min regression (listed in Tle 3). etle 5. Results of Flsifiction Test: The Effect of Rosuvsttin Mels on Desvenlfxine Prescriing, nd the Effect of Desvenlfxine Mels on Rosuvsttin Prescriing Vrile Sttin Prescriers SSRI/SNRI Prescriers (N = 111,231) (N = 113,192) Dys receiving mels promoting the opposite drug Adjusted OR (95% CI) for prescriing: Rosuvsttin Desvenlfxine (0.98, 1.00) 1.22 (1.20, 1.24) (0.94, 0.98) 1.20 (1.17, 1.23) (0.99, 1.08) 1.12 (1.08, 1.16) (0.95, 1.03) 1.46 (1.40, 1.52) Mle Femle 1.05 (1.04, 1.05) 0.83 (0.83, 0.84) Totl volume of clims within the drug clss 1.01 (1.01, 1.01) 1.00 (1.00, 1.00) Specilty Internl Medicine Fmily Medicine nd Generl Prctice 1.04 (1.03, 1.04) 1.15 (1.14, 1.16) Crdiology 1.63 (1.62, 1.63) - Psychitry (6.68, 6.85) Other 0.92 (0.91, 0.92) 1.08 (1.06, 1.10) Numer of memers in group prctice (0.92, 0.92) 0.91 (0.90, 0.92) (0.92, 0.92) 0.85 (0.84, 0.86) (0.91, 0.91) 0.71 (0.70, 0.72) % of prescriptions for rnded drugs < 25 th percentile 0.67 (0.66, 0.67) 0.48 (0.48, 0.49) Within 25 th -75 th percentile 75 th percentile 1.71 (1.70, 1.71) 1.75 (1.74, 1.77) Yers since grdution from med school (1.04, 1.06) 1.29 (1.23, 1.35) (1.04, 1.06) 1.28 (1.23, 1.34) Geogrphic region Northest Midwest 0.91 (0.91, 0.92) 1.53 (1.51, 1.55) South 1.11 (1.11, 1.11) 1.86 (1.84, 1.88) Pcific West 0.64 (0.64, 0.64) 1.29 (1.27, 1.31) Mountin West 0.87 (0.87, 0.88) 1.41 (1.37, 1.44) Popultion Density Rurl Urn 1.02 (1.02, 1.02) 0.88 (0.88, 0.89) Medin Household income in ZIP Code 0.95 (0.95, 0.95) 0.93 (0.92, 0.93) % Clims for LIS eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) % Clims for MA-PD eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) The flsifiction test ws limited to, in the left column, physicins who wrote over 20 sttin prescriptions; did not receive ny rosuvsttin pyments; nd did not receive ny desvenlfxine pyments other thn mels. The right column ws limited to physicins who wrote over 20 SSRI/SNRI prescriptions; did not receive ny desvenlfxine pyments; nd did not receive ny rosuvsttin pyments other thn mels. Prescription volume ws divided y 100 to produce 2016 Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

7 more meningful odds rtios. Medin Household Income in ZIP Code ws converted to Z-Score. etle 6. Predictors of Trget Drug Prescriing, with Low-Volume Prescriers Excluded Vrile Rosuvsttin (N = 81,097) Neivolol (N = 66,016) Olmesrtn (N = 82,321) Desvenlfxine (N = 54,788) Adjusted Odds Rtios (95% CI) Dys receiving trget drugsponsored mels (1.17, 1.17) 1.68 (1.67, 1.70) 1.50 (1.49, 1.51) 2.05 (2.00, 2.10) (1.18, 1.20) 1.82 (1.79, 1.85) 1.77 (1.75, 1.78) 2.18 (2.09, 2.28) (1.23, 1.25) 2.07 (2.01, 2.12) 1.96 (1.93, 1.98) 3.05 (2.87, 3.24) (1.33, 1.36) 2.34 (2.26, 2.42) 2.22 (2.20, 2.24) 2.59 (2.42, 2.75) Mle Femle 1.05 (1.05, 1.06) 0.90 (0.89, 0.90) 1.07 (1.06, 1.07) 0.84 (0.83, 0.85) Totl volume of clims within the drug clss 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 1.02 (1.02, 1.02) 1.00 (1.00, 1.00) Specilty Internl Medicine Fmily Medicine nd Generl Prctice 1.03 (1.03, 1.04) 1.07 (1.06, 1.07) 0.97 (0.97, 0.97) 1.15 (1.14, 1.16) Crdiology 1.66 (1.65, 1.66) 1.34 (1.33, 1.34) 0.97 (0.96, 0.97) - Psychitry (6.48, 6.64) Other 0.97 (0.96, 0.97) 1.01 (1.00, 1.02) 0.80 (0.80, 0.81) 1.25 (1.22, 1.27) Numer of memers in group prctice (0.92, 0.92) 0.96 (0.95, 0.96) 0.88 (0.87, 0.88) 0.91 (0.90, 0.92) (0.92, 0.92) 0.88 (0.87, 0.88) 0.84 (0.83, 0.84) 0.87 (0.86, 0.88) (0.92, 0.92) 0.76 (0.76, 0.76) 0.79 (0.79, 0.80) 0.74 (0.73, 0.75) % of prescriptions for rnded drugs < 25 th percentile 0.70 (0.69, 0.70) 0.47 (0.47, 0.47) 0.53 (0.53, 0.54) 0.49 (0.49, 0.50) Within 25 th -75 th percentile 75 th percentile 1.64 (1.64, 1.64) 2.26 (2.25, 2.27) 1.92 (1.91, 1.93) 1.79 (1.78, 1.81) Yers since grdution from med school (0.97, 0.99) 0.99 (0.97, 1.02) 1.18 (1.14, 1.21) 1.15 (1.09, 1.21) (0.97, 0.99) 0.94 (0.91, 0.97) 1.24 (1.20, 1.27) 1.15 (1.09, 1.21) Geogrphic region Northest Midwest 0.91 (0.91, 0.91) 1.53 (1.52, 1.54) 0.72 (0.72, 0.73) 1.49 (1.46, 1.51) South 1.10 (1.09, 1.10) 1.62 (1.61, 1.63) 0.85 (0.85, 0.86) 1.73 (1.71, 1.76) Pcific West 0.65 (0.65, 0.65) 1.23 (1.22, 1.24) 1.05 (1.04, 1.06) 1.24 (1.22, 1.27) Mountin West 0.87 (0.87, 0.88) 1.68 (1.66, 1.70) 0.93 (0.92, 0.94) 1.25 (1.22, 1.29) Popultion Density Rurl Urn 1.03 (1.02, 1.03) 0.97 (0.97, 0.97) 1.20 (1.19, 1.21) 0.92 (0.91, 0.93) Medin Household income in ZIP Code 0.96 (0.95, 0.96) 0.98 (0.97, 0.98) 0.97 (0.97, 0.98) 0.93 (0.92, 0.93) % Clims for LIS eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 0.99 (0.99, 0.99) 1.00 (1.00, 1.00) % Clims for MA-PD eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 0.99 (0.99, 0.99) 1.00 (1.00, 1.00) Prescription volume ws divided y 100 to produce more meningful odds rtios. Medin Household Income in ZIP Code ws converted to Z-Score. Physicins who prescried fewer thn 200 prescriptions were excluded from the nlysis Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

8 etle 7. Predictors of Trget Drug Prescriing, with Clim Count Stndrdized to 30-Dy Supplies Vrile Rosuvsttin (N = 111,588) Neivolol (N = 116,356) Olmesrtn (N = 121,319) Desvenlfxine (N = 113,984) Adjusted Odds Rtios (95% CI) Dys receiving trget drugsponsored mels (1.17, 1.17) 1.73 (1.72, 1.74) 1.53 (1.52, 1.54) 2.32 (2.28, 2.37) (1.18, 1.19) 1.92 (1.90, 1.95) 1.76 (1.75, 1.77) 2.47 (2.38, 2.57) (1.22, 1.24) 2.17 (2.12, 2.22) 1.96 (1.94, 1.99) 3.56 (3.37, 3.76) (1.34, 1.36) 2.72 (2.64, 2.79) 2.29 (2.27, 2.31) 2.71 (2.55, 2.87) Mle Femle 1.03 (1.03, 1.03) 0.86 (0.86, 0.86) 1.03 (1.03, 1.04) 0.83 (0.82, 0.84) Totl volume of clims within the drug clss 1.01 (1.01, 1.01) 1.01 (1.01, 1.01) 1.03 (1.03, 1.03) 1.00 (1.00, 1.00) Specilty Internl Medicine Fmily Medicine nd Generl Prctice 1.03 (1.03, 1.03) 1.07 (1.07, 1.08) 0.95 (0.95, 0.96) 1.15 (1.13, 1.16) Crdiology 1.67 (1.66, 1.67) 1.29 (1.29, 1.30) 0.90 (0.89, 0.90) - Psychitry (7.45, 7.62) Other 0.94 (0.93, 0.94) 0.94 (0.94, 0.95) 0.72 (0.71, 0.72) 1.13 (1.11, 1.15) Numer of memers in group prctice (0.92, 0.92) 0.94 (0.94, 0.94) 0.87 (0.87, 0.88) 0.88 (0.87, 0.89) (0.92, 0.93) 0.85 (0.84, 0.85) 0.85 (0.84, 0.85) 0.82 (0.81, 0.83) (0.91, 0.91) 0.71 (0.71, 0.71) 0.78 (0.78, 0.79) 0.66 (0.65, 0.67) % of prescriptions for rnded drugs < 25 th percentile 0.68 (0.67, 0.68) 0.43 (0.43, 0.44) 0.51 (0.51, 0.51) 0.49 (0.48, 0.50) Within 25 th -75 th percentile 75 th percentile 1.66 (1.66, 1.67) 2.34 (2.34, 2.35) 1.92 (1.91, 1.92) 1.79 (1.77, 1.80) Yers since grdution from med school (1.04, 1.06) 1.23 (1.20, 1.25) 1.42 (1.39, 1.45) 1.25 (1.20, 1.31) (1.03, 1.05) 1.17 (1.15, 1.19) 1.53 (1.49, 1.56) 1.26 (1.21, 1.32) Geogrphic region Northest Midwest 0.89 (0.89, 0.89) 1.47 (1.46, 1.47) 0.69 (0.69, 0.70) 1.44 (1.42, 1.46) South 1.08 (1.08, 1.08) 1.62 (1.61, 1.63) 0.84 (0.84, 0.85) 1.81 (1.79, 1.83) Pcific West 0.60 (0.59, 0.60) 1.12 (1.11, 1.12) 0.98 (0.98, 0.99) 1.26 (1.24, 1.28) Mountin West 0.86 (0.86, 0.86) 1.71 (1.69, 1.72) 0.90 (0.89, 0.91) 1.33 (1.30, 1.36) Popultion Density Rurl Urn 1.03 (1.03, 1.04) 0.97 (0.96, 0.97) 1.21 (1.21, 1.22) 0.90 (0.89, 0.90) Medin Household income in ZIP Code 0.96 (0.96, 0.96) 0.99 (0.99, 0.99) 0.98 (0.98, 0.99) 0.92 (0.91, 0.92) % Clims for LIS eneficiries 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) 0.99 (0.99, 0.99) 1.00 (1.00, 1.00) % Clims for MA-PD eneficiries 0.99 (0.99, 0.99) 1.00 (1.00, 1.00) 0.99 (0.99, 0.99) 1.00 (1.00, 1.00) Prescription volume ws divided y 100 to produce more meningful odds rtios. Medin Household Income in ZIP Code ws converted to Z-Score Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018

9 etle 8. Predictors of Rosuvsttin Prescriing s Percentge of High-Intensity Sttin Prescriptions Vrile Rosuvsttin (N = 111,588) Adjusted Odds Rtio (95% CI) Dys receiving rosuvsttin-sponsored mels (1.13, 1.14) (1.13, 1.14) (1.17, 1.19) (1.20, 1.23) Mle Femle 1.07 (1.07, 1.07) Totl volume of clims within the drug clss 1.00 (1.00, 1.00) Specilty Internl Medicine Fmily Medicine nd Generl Prctice 1.06 (1.06, 1.06) Crdiology 1.22 (1.22, 1.23) Psychitry - Other 0.93 (0.93, 0.94) Numer of memers in group prctice (0.93, 0.93) (0.92, 0.92) (0.90, 0.91) % of prescriptions for rnded drugs < 25 th percentile 0.82 (0.82, 0.82) Within 25 th -75 th percentile 75 th percentile 1.34 (1.33, 1.34) Yers since grdution from med school (1.02, 1.04) (1.04, 1.06) Geogrphic region Northest Midwest 0.99 (0.99, 1.00) South 1.19 (1.18, 1.19) Pcific West 0.68 (0.68, 0.68) Mountin West 1.01 (1.01, 1.02) Popultion Density Rurl Urn 0.97 (0.96, 0.97) Medin Household income in ZIP Code c 0.95 (0.95, 0.96) % Clims for LIS eneficiries 1.00 (1.00, 1.00) % Clims for MA-PD eneficiries 1.00 (1.00, 1.00) High-intensity sttins refers to rosuvsttin nd torvsttin. Prescription volume ws divided y 100 to produce more meningful odds rtios. c Medin Household Income in ZIP Code ws converted to Z-Score Americn Medicl Assocition. All rights reserved. Downloded From: on 10/13/2018