A 9-Year Investigation of Healthcare Industry Payments to Pulmonologists in the United States

Murayama, Anju; Kugo, Hinari; Saito, Yoshika; Saito, Hiroaki; Tanimoto, Tetsuya; Ozaki, Akihiko

doi:10.1513/annalsats.202209-827oc

Cited by 22 publications

(18 citation statements)

References 45 publications

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“…Second, there may be unmeasured confounding factors, such as the patient number and the content and reasons behind the payments provided to the dermatologists. [14][15][16] Additionally, this study exclusively relied on prescription data from the Medicare Part D database, which may have led to underestimations of the prescription amounts of dupilumab. 6,13,18 In conclusion, at least, this study provided to all dermatologists, patients, and policymakers that the industry-sponsored meal payments to dermatologists were significantly associated with higher dupilumab prescriptions and large healthcare expenditures in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…13 Then, matching the extracted dermatologist prescribers' National Provider Identifier numbers, general payments for food and beverage (hereby meal payments) to the dermatologists were extracted from the Open Payments Database between 2017 and 2021, as previously noted. 7,[14][15][16][17] This study only considered meal payments, as previous studies showed that, of several payment categories, meal payments were strongly associated with increased drug prescriptions and healthcare costs in the United States. 6,8,13,18,19 The association between meal payments for dupilumab and the dupilumab prescriptions was evaluated using a logistic generalised estimating equation (GEE), adjusting for the covariates including gender, practice region, years in practice, the graduated medical schools, and payment/prescribed year.…”

Section: Methodsmentioning

confidence: 99%

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Pharmaceutical industry‐sponsored meals are associated with increased prescriptions and Medicare spending for dupilumab among dermatologists in the United States

Murayama

2023

Evaluation Clinical Practice

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RationaleHealthcare industry sometimes make large marketing payments to physicians. Previous studies have demonstrated that there are significant associations between industry marketing practices and physicians' prescribing behaviours in several specialties. Given the current increasing introduction of many novel biologics for atopic dermatitis and increasing payments to dermatologists, the industry payments to dermatologists for atopic dermatitis drugs could be associated with their prescribing patterns in the United States.Aims and ObjectivesThis study aims to evaluate association between dermatologists' dupilumab prescription behaviours and manufacturer's sponsored meal payments to dermatologists in the United States.MethodUsing the Centers for Medicare and Medicaid Services and the Open Payments Database, this cross‐sectional analysis evaluated associations between manufacturer's sponsored meal payments to dermatologists related to dupilumab and dermatologists' dupilumab prescriptions between 2017 and 2021. Associations were evaluated using logistic generalised estimating equations (GEE) and negative binomial regression GEE models at individual dermatologist level.ResultsAmong 2852 dermatologists prescribing dupilumab, 74.5% received meal payments amounting to $1,083,919 between 2017 and 2021. Dermatologists receiving meal payments were more likely to prescribe dupilumab (odds ratio 1.50, 95% confidence interval [CI]: 1.37–1.65). There were also consistent dose–response associations between meal payments and total claims as well as Medicare spending. Dermatologists who received 1, 2–5, 6–10, and 11–15 meal payments per year reported 1.13 (95% CI: 1.03–1.24, p < 0.05), 1.35 (95% CI: 1.24–1.46, p < 0.001), 1.64 (95% CI: 1.48–1.82, p < 0.001), and 2.10 (95% CI: 1.78–2.47, p < 0.001) times more dupilumab‐related claims in the year when they received the payments than those who did not receive the payments, respectively.ConclusionThis study found that significant associations between industry‐sponsored meal payments and increased dupilumab prescriptions, shedding light on the potential influence of financial relationships on clinical practice. The findings call for heightened awareness among dermatologists, patients, and policymakers regarding the impact of these relationships on healthcare expenditures and decision‐making in the United States. Future research is warranted to further explore these associations longitudinally.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pharmaceutical industry‐sponsored meals are associated with increased prescriptions and Medicare spending for dupilumab among dermatologists in the United States

Murayama

2023

Evaluation Clinical Practice

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“…9,27,28 The inflation of US dollars from 2014 to 2021 was adjusted by dividing the payment values each year by relative consumer price index (CPI) compared to that in 2014 from the US Bureau of Labor Statistics CPI Inflation Calculator, as previously noted. 15,16 All analyses were performed using Microsoft Excel for Microsoft 365 MSO, version 2202 (Microsoft Corp), Python 3.9.12 (Python Software Foundation), and Stata version 17.0 (StataCorp). As this study was a cross-sectional analysis of publicly available information and was designed as non-human subjects study, institutional review and approval were not needed.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Additionally, the associated research payments contains indirect research payments to teaching hospitals and other institutions for the costs related to conducting research such as costs for patient recruitment and screening; data/safety monitoring committee; article publication charge and proofreading services; and drugs, supplies, and equipment used in research. 15,16 To exclude physicians who retired between 2013 and 2021 or who newly become physicians between 2013 and 2021, this study excluded physicians who deactivated or newly activated after August 2013. PHOs practicing outside the US were excluded, as the OPD only covers physician in the US.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of non-research and research industry payments to pediatric hematologist/oncologists in the United States between 2013 and 2021

Murayama¹,

Kugo²,

Kamamoto³

2023

Preprint

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Background Although financial interactions between healthcare industry and pediatric hematologist/oncologists (PHOs) contributes to and are vital for improving patient care, they could be conflicts of interest among PHOs. Nevertheless, little is known about financial relationships between healthcare industry and PHOs in the United States. Methods (procedure) This cross-sectional analysis of the Open Payments Database examined general and research payments to PHOs from healthcare industry in the United States between 2013 and 2021. PHOs were considered as physicians whose primary specialty was pediatric hematology/oncology in the National Plan and Provider Enumeration System. Payments to the PHOs were analyzed descriptively. Trends in payments were assessed using generalized estimating equation models. Results Of 2784 PHOs, 2142 (76.9%) PHOs received payments totaling $187.3 million from the healthcare industry between 2013-2021. Approximately $46.3 million (24.8%) were general payments and $137.7 million (73.5%) were funding for research where PHOs served as principal investigators (associated research funding). While 40.1% of PHOs accepted associated research funding, 72.7% of PHOs received general payments from the healthcare industry. Both general payments and associated research funding considerably increased between 2014-2019. The number of PHOs receiving general payments and associated research funding annually increased by 2.2% (95% CI: 1.2%–3.3%, p<0.001) and 5.0% (95% CI: 3.3%–6.8%, p<0.001) between 2014-2019, respectively. Conclusions This study found that majority of PHOs received non-research payments related to novel hemophilia and cancer drugs. The healthcare industry spent three fourth of their payments for research purposes. Both research and non-research payments significantly increased over the study period.

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“…[12][13][14][15] The study period was divided into two intervals (2016-2019 and 2020) to assess the impact of the COVID-19 pandemic on payment patterns, as observed in previous studies in the United States. [18][19][20][21][22][23][24] For trend analysis, we adjusted for inflation, converting all payment values to their 2020 Japanese yen equivalents using the relative annual consumer price index. Given that all data used in this study were publicly available and met the definition of non-human subjects research, institutional review board approval was not required in Japan.…”

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confidence: 99%

Financial relationships between board‐certified neurologists and the pharmaceutical industry in Japan

Murayama,

Higuchi,

Senoo

2024

Clinical and Translational Dis

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A 9-Year Investigation of Healthcare Industry Payments to Pulmonologists in the United States

Cited by 22 publications

References 45 publications

Pharmaceutical industry‐sponsored meals are associated with increased prescriptions and Medicare spending for dupilumab among dermatologists in the United States

Pharmaceutical industry‐sponsored meals are associated with increased prescriptions and Medicare spending for dupilumab among dermatologists in the United States

Evaluation of non-research and research industry payments to pediatric hematologist/oncologists in the United States between 2013 and 2021

Financial relationships between board‐certified neurologists and the pharmaceutical industry in Japan

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