Industry payments to hospitalist physicians: a 5‐year analysis of the Open Payments programme from 2014 to 2018

Pakanati, Krishna C.; Siddamreddy, Suman; Nalleballe, Krishna; Thombre, Vaishali; Sheng, Sen; Veerapaneni, Karthika; Yadala, Sisira; Kapoor, Nidhi; Dandu, Vasuki; Avula, Akshay; Meegada, Sreenath; Bere, Praveen

doi:10.1111/imj.15116

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…25 For example, a potential conflict of interest exists when the introduction of a new therapy or device coincides with higher industry payments to physicians. 26,27 A conflict of interest likely exists when there is an association between the receipt of payments for nonresearch compensation purposes and increased medication prescription. 22,28 Because of growing concerns that the wide-ranging financial ties between medical professionals and industry may disproportionately affect professional judgments and the goals of medicine, the Institute of Medicine, the predecessor to the National Academy of Medicine,…”

Section: Discussionmentioning

confidence: 99%

“…A conflict of interest in medicine exists when a physician’s ability to act in the best interests of a patient could be influenced by relationships with others . For example, a potential conflict of interest exists when the introduction of a new therapy or device coincides with higher industry payments to physicians . A conflict of interest likely exists when there is an association between the receipt of payments for nonresearch compensation purposes and increased medication prescription .…”

Section: Discussionmentioning

confidence: 99%

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Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training

Han¹,

Hogan

Holmboe

et al. 2022

JAMA Netw Open

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ImportanceFinancial incentives and conflicts of interest may influence physician decision-making. It is important to understand financial interactions between the pharmaceutical and medical device industries and newly independent physicians who have recently completed their graduate medical education using a national transparency program.ObjectiveTo identify trends in industry payments to recent graduates of Accreditation Council for Graduate Medical Education–accredited residency or fellowship programs in orthopedic surgery, neurosurgery, and internal medicine.Design, Setting, and ParticipantsThis retrospective cohort study analyzed Open Payments reports of industry payments made between July 1, 2015, and June 30, 2021, to newly independent physicians from residency or fellowship programs in neurosurgery, orthopedic surgery, and internal medicine who graduated between January 1, 2015, and December 31, 2019.ExposuresSpecialties (neurosurgery and orthopedic surgery, with internal medicine as a comparison group).Main Outcomes and MeasuresIndustry payments to newly independent physicians, including any general payments (noninvestment or nonresearch) and at least $5000 of general payments in aggregate value per year, which are considered significant financial conflicts of interest. The percentage of newly independent physicians accepting general payments during the first 6 years after graduation was analyzed by specialty and sex using cumulative incidence curves and hazard ratios (HRs) in univariable and multivariable analyses.ResultsThere were 45 745 recent graduates (28 137 men [62%]; median age at graduation, 33.0 [IQR, 31.0-35.0 years]) in neurosurgery (n = 595), orthopedic surgery (n = 3481), and internal medicine (n = 41 669). In the first 2 years of independent practice, 95% (n = 3297), 92% (n = 546), and 59% (n = 24 522) of newly independent physicians in orthopedic surgery, neurosurgery, and internal medicine, respectively, accepted any general payments. A higher percentage of the newly independent physicians in orthopedic surgery and neurosurgery accepted any general payments (orthopedic surgery vs internal medicine: HR, 5.36 [95% CI, 4.42-6.51] for women and 7.01 [95% CI, 6.35-7.73] for men; neurosurgery vs internal medicine: HR, 3.25 [95% CI, 2.24-4.72] for women and 4.08 [95% CI, 3.37-4.94] for men; P = .03). A higher percentage of male physicians compared with female physicians accepted any general payments (orthopedic surgery, 2884 of 3026 [95%] vs 413 of 455 [91%]; P &lt; .001; neurosurgery, 466 of 502 [93%] vs 80 of 93 [86%]; P = .01; and internal medicine, 15 462 of 24 609 [63%] vs 9043 of 17 034 [53%]; P &lt; .001) and at least $5000 of general payments (orthopedic surgery, 763 of 3026 [25%] vs 71 of 455 [16%]; P &lt; .001; neurosurgery, 87 of 502 [17%] vs 5 of 93 [5%%]; P &lt; .001; and internal medicine, 882 of 24 609 [4%] vs 210 of 17 034 [1%]; P &lt; .001).Conclusions and RelevanceIn this cohort study of newly independent physicians in orthopedic surgery, neurosurgery, and internal medicine, the financial relationship with potential conflicts of interest between newly independent physicians and industry began to develop soon after training programs and continued to expand in the early years of newly independent physician practice. Newly independent physicians in surgical specialties and male physicians accepted significantly higher industry payments. Further studies are needed to evaluate whether modifiable factors are associated with the future outcome of newly independent physicians accepting general payments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training

Han¹,

Hogan

Holmboe

et al. 2022

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…Although the field of ophthalmology is reflective of payment trends seen across all physicians, the type and distribution of industry payments are field-dependent. For example, a study from Pakanati et al excluded research payments when evaluating industry payments to hospitalists on the grounds that the number and value of payments were so small as to be insignificant [ 17 ]. The remainder (28.6%) of the $800 million paid to ophthalmologists by industry was in the general category ( Table 1 ), which includes a broad range of subcategories such as consulting fees, food and beverages for work-related meetings, and gifts, among others.…”

Section: Discussionmentioning

confidence: 99%

Characterizing industry payments to ophthalmologists before and after onset of the COVID-19 pandemic

Choudhry,

Burton

et al. 2023

Preprint

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Purpose The COVID-19 pandemic had profound effects on many different aspects of our healthcare system and the relationship between industry and physicians was no exception. The present database study evaluates industry payments to ophthalmologists in order to identify whether there are significant differences in industry payments to ophthalmologists before and after onset of the pandemic. Methods The Centers for Medicare & Medicaid Services Open Payments Database was queried for all ophthalmologists who received industry payments between 2018 and 2021. Pre-Covid was defined as 2018–2019 while post-Covid was defined as 2020–2021. Payment date, value, type, company making payment, and state of recipient were recorded. The top ten companies and states in terms of payment value were included in analysis. Generalized Estimating Equations (GEE) modeling was used to assess significance. Results There were 729,263 industry payments to 20,832 ophthalmologists totaling $817,892,867.54 included for analysis in this study. We found that there was a significant increase in the mean value of research payments and a significant decrease in the mean value of general payments after the onset of the pandemic (both p < 0.001). We also report significant changes in industry payments to ophthalmologists based on the company making the payment and the state in which the ophthalmologist practices. Conclusions Our results suggest that significant differences exist in industry payment patterns to ophthalmologists following onset of the COVID-19 pandemic. Understanding underlying reasons for the observed differences may improve our understanding of the relationship between industry and clinical ophthalmology.

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International comparison of pharmaceutical industry payment disclosures in the UK and Japan: implications for self-regulation, public regulation, and transparency

et al. 2023

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Background Self-regulation of payment disclosure by pharmaceutical industry trade groups is a major global approach to increasing transparency of financial relationships between drug companies and healthcare professionals and organisations. Nevertheless, little is known about the relative strengths and weaknesses of self-regulation across countries, especially beyond Europe. To address this gap in research and stimulate international policy learning, we compare the UK and Japan, the likely strongest cases of self-regulation of payment disclosure in Europe and Asia, across three dimensions of transparency: disclosure rules, practices, and data. Results The UK and Japanese self-regulation of payment disclosure had shared as well unique strengths and weaknesses. The UK and Japanese pharmaceutical industry trade groups declared transparency as the primary goal of payment disclosure, without, however, explaining the link between the two. The rules of payment disclosure in each country provided more insight into some payments but not others. Both trade groups did not reveal the recipients of certain payments by default, and the UK trade group also made the disclosure of some payments conditional on recipient consent. Drug company disclosure practices were more transparent in the UK, allowing for greater availability and accessibility of payment data and insight into underreporting or misreporting of payments by companies. Nevertheless, the share of payments made to named recipients was three times higher in Japan than in the UK, indicating higher transparency of disclosure data. Conclusions The UK and Japan performed differently across the three dimensions of transparency, suggesting that any comprehensive analysis of self-regulation of payment disclosure must triangulate analysis of disclosure rules, practices, and data. We found limited evidence to support key claims regarding the strengths of self-regulation, while often finding it inferior to public regulation of payment disclosure. We suggest how the self-regulation of payment disclosure in each country can be enhanced and, in the long run, replaced by public regulation to strengthen the industry’s accountability to the public.

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Industry payments to hospitalist physicians: a 5‐year analysis of the Open Payments programme from 2014 to 2018

Cited by 3 publications

References 17 publications

Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training

Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training

Characterizing industry payments to ophthalmologists before and after onset of the COVID-19 pandemic

International comparison of pharmaceutical industry payment disclosures in the UK and Japan: implications for self-regulation, public regulation, and transparency

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