Changes in industry marketing payments to physicians during the covid-19 pandemic: quasi experimental, difference-in-difference study

Abstract

ObjectiveTo determine changes in industry marketing payments to physicians due to the covid-19 pandemic.DesignQuasi experimental, difference-in-difference study.Data sourceUS nationwide database of licensed physicians, the National Plan and Provider Enumeration System, which was linked to a database of industry marketing payments made to physicians, Open Payments.PopulationAll licensed US physicians from 2018 to 2020 and those who received payments from industry.Main outcome measuresChanges in the value and the number of monthly industry payments physician received before (January-February 2020) and during the pandemic (April-December 2020) were assessed, adjusting for physicians’ characteristics (gender and specialty). As the control, data for the same months in 2019 were used. Industry payments by type of payments (eg, meals, travel, consulting fees, speaker compensation, honorariums), were also examined.ResultsAmong 880 589 US physicians included in this study, 267 463 (30.4%) physicians received a total of 4 117 482 non-research payments with $626 million ($710 per physician; £610; €708) in 2020 (40-44% decrease from $1047m in 2018 and $1115m in 2019). Industry payments decreased significantly in the months of the covid-19 pandemic (adjusted change in the value of −48.4%; 95% confidence interval −50.6 to −46.2; P<0.001; and adjusted change in the number of −47.4%, 95% confidence interval −47.7 to −47.1; P<0.001), particularly for meals and travel fees. No evidence was seen of a decrease in the number of industry payments for consulting and honorariums. A similar pattern was observed across physicians’ gender and specialty.ConclusionsIndustry payments to physicians, particularly those involving physical interactions such as meals and travel, substantially decreased during the pandemic. How such changes affect prescription practices and the quality of clinical practice in the long term should be investigated.

Trends in Industry Payments to Diabetologists and Endocrinologists in the United States During the COVID-19 Pandemic

“…The sharp reduction in industry payments was reported in several specialties in the United States [ 7 - 9 ]. We previously reported the decrease in per-physician payments was 52.6% in allergology and 58.6% in infectious diseases due to the COVID-19 pandemic in the United States [ 7 , 8 ].…”

The Trend in Industry Payments During the COVID-19 Pandemic Among Gastroenterologists and Hepatologists in the United States

“…However, we also observed that there were increasing trends in payments and the number of gastroenterologists receiving payments right after the onset of the COVID-19 pandemic in the United States. Several studies reported that while the payments for meals and travel remained low, speaking compensations and consulting payments were less influenced and have recovered after the pandemic [4,8].…”

“…The decrease in non-research payments from the healthcare industry to healthcare professionals during the COVID-19 pandemic is described in several specialties. Inoue et al found that the total general payments to physicians in 2020 reduced by 40-44% compared to that in 2018 and 2019 [ 4 ]. The non-research payments per internal medicine physician were reduced by 45.8% during the COVID-19 pandemic.…”

“…However, we also observed that there were increasing trends in payments and the number of gastroenterologists receiving payments right after the onset of the COVID-19 pandemic in the United States. Several studies reported that while the payments for meals and travel remained low, speaking compensations and consulting payments were less influenced and have recovered after the pandemic [ 4 , 8 ]. The reduction in non-research payments by industry is therefore likely to be temporary due to the unexpected and urgent COVID-19 pandemic and could recover to the same extent as before the pandemic.…”

“…Gastroenterology and hepatology is one of the specialties with the largest number of physicians and demand in the United States. One recent study found 87.7% of gastroenterologists received one or more non-research payments between 2014 and 2020 [ 4 ]. The study reported that total non-research payments including food and beverage, speaking fees, consulting fees, and travel and accommodation fees, increased by 11.4% each year between 2014 and 2016.…”