Open Payments Data Analysis of General and Fellowship-trained Surgeons Receiving Industry General Payments from 2016 to 2020

Abstract

Objective: To characterize industry nonresearch payments made to general and fellowship-trained surgeons between 2016 and 2020. Background: The Centers for Medicare & Medicaid Services Open Payments Data (OPD) reports industry payments made to physicians related to drugs and medical devices. General payments are those not associated with research. Methods: OPD data were queried for general and fellowship-trained surgeons who received general payments from 2016 to 2020. Payments’ nature, amount, company, covered product, and location were collected. Surgeons’ demographics, subspecialty, and leadership roles in hospitals, societies, and editorial boards were evaluated. Results: From 2016 to 2020, 44,700 general and fellowship-trained surgeons were paid $535,425,543 in 1,440,850 general payments. The median payment was $29.18. The most frequent payments were for food and beverage (76.6%) and travel and lodging (15.6%); however, the highest dollar payments were for consulting fees ($93,128,401; 17.4%), education ($88,404,531; 16.5%), royalty or license ($87,471,238; 16.3%), and travel and lodging ($66,333,149; 12.4%). Five companies made half of all payments ($265,654,522; 49.6%): Intuitive Surgical ($128,517,411; 24%), Boston Scientific ($48,094,570; 9%), Edwards Lifesciences ($41,835,544, 7.8%), Medtronic Vascular ($33,607,136; 6.3%), and W. L. Gore & Associates ($16,626,371; 3.1%). Medical devices comprised 74.7% of payments ($399,897,217), followed by drugs and biologicals ($33,945,300; 6.3%). Texas, California, Florida, New York, and Pennsylvania received the most payments; however, the top dollar payments were in California ($65,702,579; 12.3%), Michigan ($52,990,904, 9.9%), Texas ($39,362,131; 7.4%), Maryland ($37,611,959; 7%), and Florida ($33,417,093, 6.2%). General surgery received the highest total payments ($245,031,174; 45.8%), followed by thoracic surgery ($167,806,514; 31.3%) and vascular surgery ($60,781,266; 11.4%). A total of 10,361 surgeons were paid >$5000, of which 1614 were women (15.6%); in this group, men received higher payments than women (means, $53,446 vs $22,571; P<0.001) and thoracic surgeons received highest payments (mean, $76,381; NS, P=0.14). A total of 120 surgeons were paid >$500,000 ($203,011,672; 38%)—5 non-Hispanic White (NHW) women (4.2%) and 82 NHW (68.3%), 24 Asian (20%), 7 Hispanic (5.8%), and 2 Black (1.7%) men; in this group, men received higher payments than women (means, $1,735,570 vs $684,224), and NHW men received payments double those of other men (means, $2,049,554 vs $955,368; NS, P=0.087). Among these 120 highly paid surgeons (>$500,000), 55 held hospital and departmental leadership roles, 30 were leaders in surgical societies, 27 authored clinical guidelines, and 16 served on journal editorial boards. During COVID-19, 2020 experienced half the number of payments than the preceding 3 years. Conclusions: General and fellowship-trained surgeons received substantial industry nonresearch payments. The highest-paid recipients were men. Further work is warranted in assessing how race, gender, and leadership roles influence the nature of industry payments and surgical practice. A significant decline in payments was observed early during the COVID-19 pandemic.

Cross-sectional analysis of financial relationships between board certified allergists and pharmaceutical industry in Japan

“…Payments to allergists declined by over 20% in terms of amounts per allergist during this year. Comparative studies in the United States documented a significant drop in non-research payments across various specialties [13][14][15][25][26][27]34,36,[62][63][64][65], while research payments remained unaffected during the pandemic [13,[25][26][27]36,[66][67][68][69]. Notably, to mitigate the spread of COVID-19, numerous academic conferences were either canceled or deferred, and the activities of pharmaceutical representatives were considerably curtailed within healthcare facilities in Japan.…”

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

“…[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.…”