Financial Ties Between Emergency Physicians and Industry: Insights From Open Payments Data - 21/07/16

Doi : 10.1016/j.annemergmed.2016.01.014

William Fleischman, MD ^a,^⁎ , Joseph S. Ross, MD, MHS ^a,^c, Edward R. Melnick, MD, MHS ^b, David H. Newman, MD ^d, Arjun K. Venkatesh, MD, MBA ^b,^c
^a Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine, New Haven, CT
^b Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
^c Center for Outcomes Research, Yale–New Haven Hospital, New Haven, CT
^d Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

^∗Corresponding Author.

Abstract

Study objective

The Open Payments program requires reporting of payments by medical product companies to teaching hospitals and licensed physicians. We seek to describe nonresearch, nonroyalty payments made to emergency physicians in the United States.

Methods

We performed a descriptive analysis of the most recent Open Payments data released to the public by the Centers for Medicare & Medicaid Services covering the 2014 calendar year. We calculated the median payment, the total pay per physician, the types of payments, and the drugs and devices associated with payments to emergency physicians. For context, we also calculated total pay per physician and the percentage of active physicians receiving payments for all specialties.

Results

There were 46,405 payments totaling $10,693,310 to 12,883 emergency physicians, representing 30% of active emergency physicians in 2013. The percentage of active physicians within a specialty who received a payment ranged from 14.6% in preventive medicine to 91% in orthopedic surgery. The median payment and median total pay to emergency physicians were $16 (interquartile range $12 to $68) and $44 (interquartile range $16 to $123), respectively. The majority of payments (83%) were less than $100. Food and beverage (86%) was the most frequent type of payment. The most common products associated with payments to emergency physicians were rivaroxaban, apixaban, ticagrelor, ceftaroline, canagliflozin, dabigatran, and alteplase.

Conclusion

Nearly a third of emergency physicians received nonresearch, nonroyalty payments from industry in 2014. Most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs.

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Plan

Introduction

Background and Importance

Goals of This Investigation

Materials and Methods

Study Design and Data Collection and Processing

Outcome Measures and Primary Data Analysis

Results

Limitations

Discussion

	Please see page 154 for the Editor’s Capsule Summary of this article.
	Supervising editor: Brendan G. Carr, MD, MS
	Author contributions: WF and AKV conceived and designed the study. AKV supervised the conduct of the study. WF conducted data processing and analysis and drafted the article. All authors contributed substantially to article revision. WF takes responsibility for the paper as a whole.
	Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). Dr. Ross is supported by the National Institute on Aging (K08 AG032886) and by the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program. He receives research support through Yale University from Medtronic, Inc. and Johnson & Johnson to develop methods of clinical trial data sharing, from the Centers for Medicare & Medicaid Services (CMS) to develop and maintain performance measures that are used for public reporting, and from the Food and Drug Administration to develop methods for postmarket surveillance of medical devices. Dr. Melnick is supported by grant K08HS021271 from the Agency for Healthcare Research and Quality. Dr. Venkatesh is supported by the Emergency Medicine Foundation Health Policy Scholar Award. He also receives support from the CMS to develop and maintain performance measures that are used for public reporting.
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