The Dawn of Transparency

Abstract

Background The Physician Payments Sunshine Act (PSSA) is a government initiative that requires all biomedical companies to publicly disclose payments to physicians through the Open Payments Program (OPP). The goal of this study was to utilize the OPP database and evaluate all non-research related financial transactions between plastic surgeons and biomedical companies. Methods Using the first wave of OPP data published on September 30, 2014, we studied the national distribution of industry payments made to plastic surgeons during a five month period. We explored whether a plastic surgeon’s scientific productivity, (as determined by their h-index), practice setting (private versus academic), geographic location, and subspecialty were associated with payment amount. Results Plastic surgeons (N=4,195) received a total of $5,278,613. The median (IQR) payment to a plastic surgeon was $115($35–298); mean $1,258. The largest payment to an individual was $341,384. The largest payment category was non-CEP speaker fees ($1,709,930) followed by consulting fees ($1,403,770). Plastic surgeons in private practice received higher payments per surgeon compared to surgeons in academic practice (median [IQR] $165[$81 – $441] vs. median [IQR] $112 [$33–$291], rank-sum p<0.001). Among academic plastic surgeons, a higher h-index was associated with 77% greater chance of receiving at least $1000 in total payments (RR/10 unit h-index increase=1.47 1.77 2.11, p<0.001). This association was not seen among plastic surgeons in private practice (RR=0.89 1.09 1.32, p<0.4). Conclusion Plastic surgeons in private practice receive higher payments from industry. Among academic plastic surgeons, higher payments were associated with higher h-indices.

Assessment of Pharmaceutical Company and Device Manufacturer Payments to Gastroenterologists and Their Participation in Clinical Practice Guideline Panels

“…Our data clearly show the relative importance of direct financial rewards for physicians, which is consistent with findings in other specialties, 65 , 68 , 69 and accounted for nearly two-thirds of all expenditures reported to the Open Payment repository. Most of these payments were listed as compensation for talks and presentations.…”

Characteristics of Industry Payments to Ophthalmologists in the Open Payments Database

“…The manufacturers making the most payments to ophthalmologists were also top payers in dermatology (n = 5), obstetrics and gynecology (n = 1), and plastic surgery (n = 1). 8,14,15 Similar to other specialties, ophthalmologists were reported to have received most payments in the form of meals. 2,[8][9][10][14][15][16][17][18][19][20][21] Although perhaps seemingly benign to the recipient, the acceptance of industry payments (especially meals) is not without potential consequence.…”

“…The percentage of royalties distributed as general payments to ophthalmologists (21.68%) was less than that reported to have been received by neurosurgeons (74%), orthopedic surgeons (69%), and obstetrician-gynecologists (50%) but higher than royalty payments distributed to pediatricians (15%), plastic surgeons (4%), urologists (11%), otolaryngologists (2.4%), cardiothoracic surgeons (3.8%), dermatologists (0.3%), and emergency medicine physicians (1.4%). 8,10,14,15,17,19,[24][25][26][27] Although the CMS OPD is free and publicly available, most of the population is unaware of this resource. Results from a 2018 ophthalmologic survey of 407 participants indicated that only 30 patients (7.7%) knew of the OPD and only 12 (3.1%) attempted to access the database (11 patients [2.8%] in this study were physicians).…”

Follow the money: Investigating gender disparity in industry payments among senior academics and leaders in plastic surgery

“…For example, research funding has been shown to positively impact scholarly productivity [5][6][7], whereas sponsored speakerships reflect a surgeon's expertise and status as a key opinion leader [8]. However, female academic surgeons face an industry pay gap [9][10][11][12]. Within academic plastic surgery, female surgeons receive fewer industry payments and a lower monetary value per payment compared to their male counterparts [11].…”