5 January 2016. An analysis of industry payments to physicians shows cardiovascular specialists and neurosurgeons were the specialties most likely to receive payments from pharmaceutical and medical device companies. The findings appear in this month’s issue of the journal Mayo Clinic Proceedings.
The research team from University of California in San Diego, led by radiation oncologist Jona Hattangadi-Gluth, analyzed entries from the Open Payments database, established to provide more transparency in relationships between physicians and manufacturers. The program requires and collects data from pharmaceutical and medical device companies on payments to physicians for research activities, gifts, speaking fees, meals, and travel. The database is run by Centers for Medicare and Medicaid Services and authorized by a provision of the Patient Protection and Affordable Care Act in 2010.
Open Payments began collecting entries in August 2013, and the UC-San Diego team reported on data provided from August through December 2013. In that time, pharmaceutical and medical device companies made some 2.4 million payments to physicians, valued at $475 million. Support for research activities accounted for $45 million, just under 10 percent of the total.
In their analysis Hattangadi-Gluth and colleagues found:
- About half of the payments, $222 million or 47 percent, went to physicians in orthopedic surgery and internal medicine, with each group receiving about $111 million.
- More than 3 in 4 cardiovascular and neurosurgical specialists, 78 and 77 percent respectively, received payments from manufacturers, making them the most likely recipients. Les than 1 in 10 pathologists (9%) received payments, the least favored specialty.
- Specialties using higher levels of intervention — e.g., gastroenterology, cardiology and orthopedics — generally received more money per physician, which the authors attribute to the specialists’ use of both drugs and medical devices in their work.
Open Payments also requires manufacturers to document any physician ownership or investment interests held in those companies. The researchers found pharmaceutical and medical device companies invested some $310 million in nearly 2,100 physician businesses, valued at $447 million.
Hattangadi-Gluth says in a UC-San Diego statement that financial links between manufacturers and physicians are not necessarily a bad thing. “During the last few decades,” she says, “physicians have become much more engaged in the development of novel drugs and devices, which is critical to bringing innovation to patients.” The authors recommend looking more closely, however, at the effects of transparency on physician and patient decision making.
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