Evaluation of Industrial Compensation to Cardiologists in 2015

Abstract

The categorization and characterization of pharmaceutical and device manufacturers or group purchasing organization payments to clinicians is an important step toward assessing conflicts of interest and the potential impact of these payments on practice patterns. Payments have not previously been compared among the subspecialties of cardiology. This is a retrospective analysis of the Open Payments database, including all installments and payments made to doctors in the calendar year 2015 by pharmaceutical and device manufacturers or group purchasing organization. Total payments to individual physicians were then aggregated based on specialty, geographic region, and payment type. The Gini Index was further employed to calculate within each specialty to measure income disparity. In 2015, a total of $166,089,335 was paid in 943,744 payments (average $175.00 per payment) to cardiologists, including 23,372 general cardiologists, 7,530 interventional cardiologists, and 2,293 cardiac electro-physiologists. Payments were mal-distributed across the 3 subspecialties of cardiology (p <0.01), with general cardiology receiving the largest number (73.5%) and total payments (62.6%) and cardiac electrophysiologists receiving significantly higher median payments ($1,662 vs $361 for all cardiologists; p <0.01). The Medtronic Company was the largest single payer for all 3 subspecialties. In conclusion, pharmaceutical and device manufacturers or group purchasing organizations continue to make substantial payments to cardiac practitioners with a significant variation in payments made to different cardiology subspecialists. The largest number and total payments are to general cardiologists, whereas the highest median payments are made to cardiac electrophysiologists. The impact of these payments on practice patterns remains to be examined.

A Five-Year Analysis of Industry Payments to Sleep Neurologists From 2014 Through 2018

“…inequality among the physicians who received payments from the industry. The same trend has been noted in other studies analyzing industry payments to cardiologists and neurologists [5][6][7][8][9][10]. The trend of payments in the top 10 physicians was not much different from the total cohort; compensation for services (41.3%) and royalty and/or licensing fees (31.6%) were the most paid categories.…”

Association between physician characteristics and payments from industry in 2015–2017: observational study

“…The characteristics of physicians who receive large payments from industry remain incompletely characterised. Several studies have reported that industry payments may vary substantially based on physicians’ sex,14–17 clinical experience16 18 and specialty 10 15 19 20. In addition, a recent study that reported association of physicians’ alma mater, medical school ranking and their prescription patterns (for opioids), sheds light on the importance of medical education on physician behaviour, which could potentially impact how industry approach physicians 21.…”

Analysis of payments to GI physicians in the United States: Open payments data study

“…The data collection was started in 2013 and first reported in 2014. Recent studies on Open Payments have shown the significant financial interaction between the medical industry and physicians in various specialties 8‐16 . This also brought to light the inaccuracies of financial disclosure statements and conflicts of interests, thus advocating for more stringent enforcement of disclosure policies 6,17,18 .…”