Trends of Industry Payments in Neurology Subspecialties

Nalleballe, Krishna; Veerapaneni, Karthika; Harada, Yoshifumi; Veerapaneni, Poornachand; Arulprakash, Narenraj; Lopez-Castellanos, Jose R; Sheng, Sen; Rowen, Julia; Dandu, Vasuki; Onteddu, Sanjeeva; Siddamreddy, Suman

doi:10.7759/cureus.9492

Cited by 5 publications

(7 citation statements)

References 15 publications

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“…In our analysis, the top 10 physicians received close to 85% of total payments, which shows a gross 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 - 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.…”

Section: Discussionsupporting

confidence: 83%

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

Dandu

Siddamreddy

Thombre

et al. 2020

Cureus

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Background and objectives Sleep medicine has been one of the fastest-growing medical fields in recent years. The industry plays a big role in developing new medications and devices for both diagnosis and treatment of sleep-related problems. We analyzed payments made by industry to physicians from 2014 through 2018 based on the Open Payments Program data. Methods Centers for Medicare and Medicaid Services Open Payment Program and American Board of Psychiatry and Neurology databases were explored to elicit financial relationships between industry and sleep neurologists. Results Payments made by industry to sleep neurologists have been steadily increasing from 2014 through 2018. Approximately 16% to 22% of sleep certified neurologists received payments from industry during the study period. Interestingly, the payments made to the top 10% of the sleep physicians contributed approximately 85% to 96% of the total payments. The top two categories to which the highest payments were made were compensation for services and royalty and/or licensing fees. Silenor® (doxepin), Xyrem® (sodium oxybate), Aptiom® (eslicarbazepine acetate), Belsomra® (suvorexant), and Fycompa® (perampanel) were most of the drugs, which made the highest payments, that got approved by the Food and Drug Administration in the last decade. Conclusions It seems that the industry is spending significant amounts of money in educating the physicians and in marketing the newer drugs. This analysis of the data on payments from industry is very useful in identifying any potential conflicts of interest from physicians. Further analyses are needed to study the trends of physician practice behavior and decision making.

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Section: Discussionsupporting

confidence: 83%

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

Dandu

Siddamreddy

Thombre

et al. 2020

Cureus

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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%

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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“…Such information about eligible payments has been available through the CMS OPP website since August 2013. Physician-industry financial relationships have been reported in several clinical specialties [ 7 , 8 ], and this study reports the trends and details of such payments in the field of nephrology.…”

Section: Introductionmentioning

confidence: 99%

Industry Payments to Nephrologists in the United States

Pakanati

Kovvuru²,

Thombre³

et al. 2021

Cureus

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Background Industry payments to physicians raise concerns about conflicts of interest that have the potential to impact patient care. In this study, we explored nonresearch and nonownership payments from industry to nephrologists to identify trends in compensation. Methodology Using data from the Centers for Medicare and Medicaid Services (CMS), we explored financial relationships between industry and US nephrologists from 2014 to 2018. We analyzed payment characteristics including payment categories, payment distribution among physicians, regional trends, and biomedical manufacturers. Results In this retrospective study, a total of $75,174,999 was paid to nephrologists in the United States during the study period (i.e., 2014-2018). The number of board-certified nephrologists receiving payment from the industry increased from 11,642 in 2014 to 13,297 in 2018. Among board-certified nephrologists, 56% to 63% received industry payments during the study period. The total payments to nephrologists increased from $13,113,512 in 2014 to $16,467,945 in 2017, with consulting fees (24%) and compensation for services other than consulting (35%) being the highest-paid categories. The top 10% of physician beneficiaries collected 90% of the total industry payments. Conclusions A small proportion of US nephrologists consistently received the majority of industry payments, the value of which grew over the study period.

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Trends of Industry Payments in Neurology Subspecialties

Abstract: Background Open Payments is a national disclosure program to promote transparency by the public disclosure of financial relationships between the pharmaceutical and medical device industries and physicians.

Cited by 5 publications

References 15 publications

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

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

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

Industry Payments to Nephrologists in the United States

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