The Physician Payments Sunshine Act

Abstract

Objective/Purpose To review data for ophthalmologists published online from the Physician Payments Sunshine Act. Design Retrospective data review using a publicly available electronic database Methods: Main Outcome Measures A database was downloaded from the Centers for Medicare and Medicaid Services (CMS) Website under Identified General Payments to Physicians and a primary specialty of ophthalmology. Basic statistical analysis was performed including mean, median and range of payments for both single payments and per provider. Data were also summarized by category of payment, geographic region and compared with other surgical subspecialties. Results From August 1, 2013 to December 31, 2013, a total of 55,996 individual payments were reported to 9,855 ophthalmologists for a total of $10,926,447. The mean amount received in a single payment was $195.13 (range $0.04–$193,073). The mean amount received per physician ID was $1,108 (range $1–$397,849) and median amount $112.01. Consulting fees made up the largest percentage of fees. There was not a large difference in payments received by region. The mean payments for the subspecialties of dermatology, neurosurgery, orthopedic surgery and urology ranged from $954–$6,980, and median payments in each field by provider identifier ranged from $88–$173. Conclusions A large amount of data was released by CMS for the Physician Payment Sunshine Act. In ophthalmology, mean and median payments per physician did not vary greatly from other surgical subspecialties. Most single payments were under $100, and most physicians received less than $500 in total payments. Payments for consulting made up the largest category of spending. How this affects patient perception, patient care and medical costs warrants further study.

The Dawn of Transparency

“…Moreover, the availability of OPP data is limited to a 5-month reporting period, which may not give a true picture of the entire physician-industry financial landscape. However, this limitation will be further addressed as future iterations of the database release annual data, and similar studies to ours continue to report on preliminary OPP database findings (11, 36, 37). …”

“…The results from this study demonstrate that a total of $5,278,613 was paid to 4,195 plastic surgeons over a five month period. The median payment to plastic surgeons was $115 which in comparison, is within the range of other medical specialties in the OPP: $102 to dermatologists; $88 to neurosurgeons; and $173 to urologists (11). Amongst payment categories, the largest amount was paid for serving as a member of a non-CEP speaker bureau (32%) followed by consulting fees (27%).…”

Disclosure of Industry Payments to Physicians

“…These evaluations also found a high prevalence of payments with specialty variability, as well as high values of payments attributed to cardiology and orthopedic surgery. In addition, our data differ from the Massachusetts data in the nature of payments by providing additional detail to the distribution of payments, where a large proportion of Massachusetts payments fell under the broad category of “compensation for bona fide services 9 .” Other analyses of Open Payments data also found similar variation amongst a limited number of surgical specialties 24-26 , although a comprehensive analysis of medical and other specialties is absent. Certain specialties may have greater research and development involvement resulting in royalty and licensing payments 27 .…”

Here Comes the Sunshine: Industry’s Payments to Cardiothoracic Surgeons

“…The accuracy and applicability of the data remains to be determined, and carries with it already acknowledged limitations such as a lack of reporting of drug sample and CME-certified program payments 17 . However, these limitations should be at least partially addressed as the PPSA evolves over time, and as studies similar to ours report on preliminary OPP database findings 16, 19 .…”

“…However, a large body of literature has previously explored the impact of financial COIs on clinical care, research outcomes, and physician behavior. 10-13, 19-25 Although many studies suggest that industry's support for research, clinical care, and innovation is essential, there is frequently concern that financial relationships between commercial entities and clinical providers carry the potential for undue influence. 26-28 Consistent with this notion, a 2012 Cochrane review recently demonstrated that research studies involving drug and/or device development that are sponsored by industry tend to lead to more favorable efficacy compared with non-industry sponsored studies 14 .…”