Industry Relationships With Medical Oncologists: Who Are the High-Payment Physicians?

Abstract

PURPOSE: Many oncologists have relationships with industry. Previous work has shown that these payments are usually modest; however, there exist a subset of medical oncologists who receive more than $100,000 US dollars (USD) annually. Here, we describe the characteristics of these physicians. METHODS: This retrospective cohort study used the Open Payments data set to identify all US-based medical oncologists/hematologists who received $100,000+ USD in general payments linked to cancer medications in 2018. Open Payments and a web-based search were used to identify physician characteristics, demographics, research profile, and leadership positions. RESULTS: One hundred thirty-nine medical oncologists received > $100,000 USD in general payments. The median payment was $154,613 USD, and the total payment was $24.2 million USD. These high-payment physicians represent 1% of all US medical oncologists (N = 10,620) yet account for 37% of all industry payments in 2018. Sixty percent (84 of 139) and 21% (29 of 139) of these high-payment physicians hold hospital and specialty association leadership roles, respectively. One quarter (24%, 33 of 139) serve on journal editorial boards, and 10% (14 of 139) have authored clinical practice guidelines; 72% (100 of 139) hold faculty appointments. CONCLUSION: A small number of medical oncologists receive very high payments from the pharmaceutical industry. These physicians hold major leadership roles within oncology. Further work is needed to understand the extent to which these conflicts of interest may shape clinical practice and policy.

Industry payments to pathologists in the USA between 2013 and 2021

“…In a study of 35 pathology journal editors from 2014 to 2020 using the Open Payments Database, Jacobs et al 7 reported that 48.8% of the editors received at least one industry payments, with male editors receiving a median general payment of $17 846 and female editors receiving $9569, which were much higher than our findings for all pathologists. Previous research on industry payments to physicians has shown that those receiving the largest general payments held leadership positions such as hospital and faculty directors, journal editors, clinical guideline authors and board members of professional medical associations 18 19. Although this study did not comprise demographic data on the clinical and academic positions of pathologists, those who received the largest payments could hold clinical and academic leadership roles and should adhere to higher ethical standards than other pathologists 20…”

Pharmaceutical payments to Japanese board-certified dermatologists: a 4-year retrospective analysis of personal payments from pharmaceutical companies between 2016 and 2019

“…We included only payments for lecturing, consulting, and writing purposes, and could not collect payments for more prevalent categories such as meals, travel and accommodations, and educations, which were widely made to dermatologists in the United States. Compensation for lecturing, consulting and writing was generally targeted at physicians with extensive clinical or research experience, typically physicians working in universities or general hospitals 6 , 16 , 33 . According to a survey by the Japanese Ministry of Health, Labor, and Welfare in 2020, 60.3% of dermatologists worked in clinics and hospitals with less than 20 inpatient beds in Japan 34 .…”

Oncology Drug Prescribing: The Influences of Greed and Fear

“…AFFILIATION 1 The University of Chicago, Chicago, IL CORRESPONDING AUTHOR Mark J. Ratain, MD, The University of Chicago, 5841 S. Maryland Ave, MC 2115, Chicago, IL 60637; e-mail: mjr1@uchicago.edu.…”

“…In this context, it is important to take a closer look at the data analyzed by Wright et al 1 Their analysis focused on general payments but did not separately analyze the payments by subcategories, such as consulting fees and speakers bureaus (ie, “compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program”). Noting that 25% of those receiving high payments had 0-2 publications in 2018, only 24% had served on an editorial board in the preceding five years and only 56% practiced in academic institutions, many of those oncologists receiving high payments appear to have been rewarded for their nonacademic activities, potentially a large number of prescriptions for specific products.…”

“…Although one would hope that drug prescribing would be evidence-based, greed and fear also factor into such decisions. Wright et al 1 have used the Open Payments database to analyze one source of greed, high payments (in 2018) by pharmaceutical companies to high-profile physicians, also known as key opinion leaders. 2 This study identified the 1% of oncologists who received more than $100,000 US dollars in general payments associated with specific marketed cancer drugs, in aggregate totaling $24 million US dollars, comprising 37% of total industry payments to US oncologists for that year.…”