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Miller SL, Haslam A, Prasad V. Financial conflicts of interest among presenters, panellists and moderators at haematology and oncology FDA workshops. Eur J Clin Invest 2024; 54:e14184. [PMID: 38407501 DOI: 10.1111/eci.14184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To assess the characteristics and financial conflicts of interest of presenters, panellists and moderators at haematology and oncology workshops held jointly with or hosted by the US FDA. SETTING We included information on all publicly available haematology or oncology FDA workshop agendas held between 1 January 2018 and 31 December 2022. EXPOSURE General and research payments reported on Open Payments, industry funding to patient advocacy organizations reported on their webpages or 990 tax forms and employment in both pharmaceutical and regulatory settings. RESULTS Among physicians eligible for payments, 78% received at least one payment from the industry between 2017 and 2021. The mean general payment amount was $82,170 for all years ($16,434 per year) and the median was $14,906 for all years ($2981 per year). Sixty-nine per cent of patient advocacy speakers were representing organizations that received financial support from the pharmaceutical industry. Among those representing regulatory agencies or pharmaceutical companies, 16% had worked in both settings during their careers. CONCLUSIONS AND RELEVANCE Our findings in this cross-sectional study show a majority of US-based physician presenters at haematology and oncology workshops held jointly with members of the US FDA have some financial conflict of interest with the pharmaceutical industry. These findings support the need for clear disclosures and suggest that a more balanced selection of presenters with fewer conflicts may help to limit bias in discussions between multiple stakeholders.
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Affiliation(s)
- Sarah L Miller
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Schnog JB, Samson MJ, Gersenbluth I, Duits AJ. Pharmaceutical Industry Payments to Medical Oncologists in the Netherlands: Trends and Patterns Provided by an Open-Access Transparency Data Set. JCO Oncol Pract 2024:OP2300533. [PMID: 38354335 DOI: 10.1200/op.23.00533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/24/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024] Open
Abstract
PURPOSE Health care expenditure related to oncologic treatments is skyrocketing although many treatments offer marginal, if any, clinical benefit. Financial conflicts of interest (fCOI) resulting from pharmaceutical industry (pharma) payments to physicians is increasingly recognized as a predictive factor for regulatory board approval and guideline incorporation of low-value treatments. We sought to study the extent to which pharma payments to medical oncologists occur in the Netherlands, the amount of money involved, and whether these occur more frequently and are higher for key opinion leaders (KOLs). METHODS In our cross-sectional retrospective database study, we used several Dutch open-access databases and extracted data registered between 2019 and 2021. RESULTS A cumulative amount of €899,863 was paid to 48.8% of the 408 registered medical oncologists. Over time, there was a marked decline in both the proportion of medical oncologists receiving payments (from 40.4% in 2019 to 19.1% in 2021) and the mean annual value of payments (from €2,962 in 2019 to €2,188 in 2021) with the latter mainly resulting from a decline in hospitality-related transactions. KOLs were more likely to receive industry payments and received a higher median payment value. DISCUSSION Our findings should contribute to the increasing awareness in the Netherlands of the potential effects of fCOI.
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Affiliation(s)
- J B Schnog
- Department of Hematology-Medical Oncology, Curaçao Medical Center, Willemstad, Curaçao
- Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
| | - M J Samson
- Department of Radiation Oncology, Curaçao Medical Center, Willemstad, Curaçao
| | - I Gersenbluth
- Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
| | - A J Duits
- Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
- Department of Medical Education, Curaçao Medical Center, Willemstad, Curaçao
- Institute for Medical Education, University Medical Center Groningen, Groningen, the Netherlands
- Red Cross Blood Bank Foundation, Willemstad, Curaçao
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Murayama A. Industry-sponsored meal payments are associated with prescriptions and Medicare expenditures on brand-name colchicine in the United States. Int J Rheum Dis 2024; 27:e14962. [PMID: 37923570 DOI: 10.1111/1756-185x.14962] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
AIM To investigate the association between industry-sponsored meal payments and the prescribing patterns of brand-name colchicines, namely Colcrys and Mitigare, among Medicare beneficiaries in the United States from 2014 to 2021. METHODS This cross-sectional study utilized data from the Open Payments Database and Medicare Part D covering the years 2014 to 2021. The study included 54 836 physicians who submitted more than 10 colchicine claims. Exposure was defined as the receipt of one or more industry-sponsored meals from the manufacturers of Colcrys or Mitigare. The primary outcomes included the likelihood of prescribing Colcrys and Mitigare, as well as the associated number of claims and Medicare expenditures. RESULTS Among 54 836 eligible physicians, 44.9% received meal payments from the Colcrys manufacturer, and 8.0% from the Mitigare manufacturer, over the eight-year study period. The average meal payment value was $14.9 for Colcrys and $15.1 for Mitigare. The receipt of meal payments was significantly associated with an increased likelihood of prescribing Colcrys (odds ratio: 1.24 [95% CI: 1.21-1.27], p < .001) and Mitigare (odds ratio: 3.54 [95% CI: 2.98-4.20], p < .001). Each additional meal payment corresponded with a significant increase in Medicare expenditures: $55.4 (95% CI: $48.3-$62.5, p < .001) for Colcrys and $153.7 (95% CI: $17.7-$289.6, p = .03) for Mitigare. These associations remained consistent across different specialties and genders. CONCLUSION This study reveals that receipt of meal payments from manufacturers of brand-name colchicine was significantly associated with an increased rate of prescriptions for these brand-name drugs, leading to higher Medicare expenditures in the United States.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Murayama A, Kamamoto S, Kugo H, Saito H, Ozaki A. Research and Nonresearch Industry Payments to Nephrologists in the United States between 2014 and 2021. J Am Soc Nephrol 2023; 34:1709-1720. [PMID: 37488676 PMCID: PMC10561777 DOI: 10.1681/asn.0000000000000172] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/29/2023] [Indexed: 07/26/2023] Open
Abstract
SIGNIFICANCE STATEMENT Concerns about the financial relationships between nephrologists and the health care industry have been reported in the United States over the past decade. However, since the 2014 launch of the federal transparency database, Open Payments, few documents have explored the whole picture of research and nonresearch payments to US nephrologists from industry sources. In this study, the authors found that 87% of nephrologists have received nonresearch payments, and the aggregate amount of these payments has been increasing since 2014. Only 12% of nephrologists received research payments; these recipients were disproportionately male. In addition, the top 5% of nephrologists receiving nonresearch funds received 81% of all such payments. Nonresearch payments were larger among male nephrologists than among female nephrologists and increased by 8% annually among male nephrologists between 2014 and 2019. BACKGROUND Financial relationships between nephrologists and the health care industry have been a concern in the United States over the past decade. METHODS To evaluate industry payments to nephrologists, we conducted a cross-sectional study examining nonresearch and research payments to all US nephrologists registered in the National Plan and Provider Enumeration System between 2014 and 2021, using the Open Payments database. Payment data were descriptively analyzed on the basis of monetary value, and payment trends were evaluated by using a generalized estimating equations model. RESULTS From 2014 through 2021, 10,463 of 12,059 nephrologists (87%) received at least one payment from the US health care industry, totaling $778 million. The proportion of nephrologists who did not receive nonresearch payments varied each year, ranging from 38% to 51%. Nonresearch payments comprised 22% ($168 million) of overall industry payments in monetary value but 87% in the number of payments. Among those receiving payments, the median per-physician 8-year aggregated payment values were $999 in nonresearch payments and $102,329 in associated research payments. Male nephrologists were more likely than female nephrologists to receive research payments, but the per-physician amount did not differ. However, nonresearch payments were three times larger for male nephrologists and increased by 8% annually between 2014 and 2019 among male nephrologists but remained stable among female nephrologists. The top 5% of nephrologists receiving nonresearch payments received 81% of all such payments. CONCLUSIONS Between 2014 and 2021, 87% of US nephrologists received at least one payment from the health care industry. Notably, nonresearch payments to nephrologists have been increasing since the Open Payments database's 2014 launch. Male nephrologists were more likely than female nephrologists to receive research payments.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Japan
| | - Sae Kamamoto
- School of Medicine, Hamamatsu University, Hamamatsu, Japan
| | - Hinari Kugo
- School of Medicine, Tohoku University, Sendai, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Tokyo, Japan
- Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital, Fukushima, Japan
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Murayama A. Financial Conflicts of Interest Among the Authors of the Clinical Practice Guidelines for Rheumatoid Arthritis in Japan. Cureus 2023; 15:e46650. [PMID: 37937008 PMCID: PMC10627577 DOI: 10.7759/cureus.46650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To assess the financial relationships between pharmaceutical companies and authors of the 2020 Japan College of Rheumatology Clinical Practice Guidelines (CPG) for the Management of Rheumatoid Arthritis and to evaluate the quality of evidence supporting the guideline recommendations. Methods This retrospective study evaluated financial relationships between all 27 authors of the CPG and pharmaceutical companies in Japan. Personal payments from pharmaceutical companies to these authors between 2016 and 2020 were extracted from publicly disclosed databases for each pharmaceutical company. The quality of the evidence supporting the CPG recommendations was also assessed. Results All 27 authors received personal payments from pharmaceutical companies, totaling $3,683,048 over five years. The median and mean payments per author were $101,624 and $136,409, respectively. Speaking compensations accounted for more than 80% of all personal payments. More than 77.8% (21 authors), 66.7% (18 authors), and 51.9% (14 authors) received more than $10,000, $50,000, and $100,000 in total payments over the five years, respectively. Nevertheless, these financial relationships between the CPG authors and pharmaceutical companies were not disclosed. More than 81.8% of the CPG recommendations were supported by low- or very-low-quality evidence. Of the strong recommendations, 66.7% were supported by low- or very-low-quality evidence. Conclusion Even though all CPG authors received substantial amounts of personal payments from pharmaceutical companies, these conflicts of interest (COIs) were not disclosed in the CPG. These findings underscore the urgent need for policy interventions to enhance transparency, integrity, and reliability in the development of CPGs in Japan.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, JPN
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
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Harrison RA, Majd NK, Johnson MO, Urbauer DL, Puduvalli V, Khasraw M. Characterization of industry relationships in oncology. Cancer 2023; 129:2848-2855. [PMID: 37227811 DOI: 10.1002/cncr.34852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/08/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Collaborative relationships between academic oncology and industry (pharmaceutical, biotechnology, "omic," and medical device companies) are essential for therapeutic development in oncology; however, limited research on engagement in and perceptions of these relationships has been done. METHODS Survey questions were developed to evaluate relationships between academic oncology and industry. An electronic survey was delivered to 1000 randomly selected members of the American Society of Clinical Oncology, a professional organization for oncologists, eliciting respondents' views around oncology-industry collaborations. The responses were analyzed according to prespecified plans. RESULTS There were 225 survey respondents. Most were from the United States (70.0%), worked at an academic institution (60.1%), worked in medical oncology (81.2%), and had an active relationship with industry (85.8%). One quarter (26.7%) of respondents reported difficulty establishing a relationship with industry collaborators, and most respondents (75%) did not report having had mentorship in developing these relationships. The majority (85.3%) of respondents considered these collaborations important to their careers. Respondents generally thought that scientific integrity was preserved (92%), and most respondents (95%) had little concern over the quality of the collaborative product. Many (60%) shared concerns over potential conflict of interest if an individual with a compensated relationship promoted an industry product for clinical care/research, yet most respondents (67%) stated these relationships did not shape their interactions with patients. CONCLUSIONS This study provides novel data characterizing the nature of collaborative relationships between clinicians, researchers, and industry in oncology. Although respondents considered these collaborations an important part of clinical and academic oncology, formal education or mentorship around these relationships was rare. Conflicting findings around conflict of interest highlight the importance of more dedicated research in this area. PLAIN LANGUAGE SUMMARY Business enterprises in health care play a central role in cancer research and care, driving the development of new medical testing, drugs, and devices. Effective working relationships among clinicians, researchers, and these industry partners can promote innovative research and enhance patient care. Study of these collaborations has been limited to date. Through distribution of a questionnaire to cancer clinicians and researchers, we found that most participants consider these relationships valuable, though they find establishing such relationships challenging partly because of gaps in educational programs in this area. Our findings also highlight the need for further policy around the potential bias these relationships can introduce.
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Affiliation(s)
- Rebecca A Harrison
- Division of Neurology, BC Cancer, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nazanin K Majd
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Margaret O Johnson
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Diana L Urbauer
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Vinay Puduvalli
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mustafa Khasraw
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
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Murayama A, Kugo H, Saito Y, Saito H, Tanimoto T, Ozaki A. A 9-Year Investigation of Healthcare Industry Payments to Pulmonologists in the United States. Ann Am Thorac Soc 2023; 20:1283-1292. [PMID: 36961514 DOI: 10.1513/annalsats.202209-827oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/24/2023] [Indexed: 03/25/2023] Open
Abstract
Rationale: The healthcare industry sometimes makes payments to physicians for nonresearch and research purposes in the United States. Objectives: We aimed to evaluate the trends in nonresearch and research industry payments to pulmonologists since the inception of the Open Payments database in 2013. Methods: Using the Open Payments database between August 2013 and December 2021, this population-based observational cohort study examined nonresearch and research payments made by the healthcare industry to pulmonologists registered in the National Plan and Provider Enumeration System in the United States. We performed descriptive analyses on payment data and generalized estimating equations for payment trends. Results: Of 12,488 active pulmonologists, 11,074 (88.7%) accepted a total of 2,246,412 payments totaling $1,053,344,669. Total payments were $253,405,965 (24.1%) in nonresearch, $17,382,904 (1.7%) in direct research, and $782,555,800 (74.3%) in associated research payments between 2013 and 2021. Median per-physician payments (interquartile range) were $2,342 ($496 to $8,299) for nonresearch, $4,688 ($1,435 to $21,803) for direct research, and $95,927 ($20,300 to $344,995) for associated research payments. The top 1%, 5%, and 10% of pulmonologists accepted 37.3%, 71.9%, and 83.7% of the total nonresearch payments. The per-physician nonresearch payments increased by 2.9% (95% confidence interval [CI], 1.2 to 4.7; P = 0.001) annually between 2014 and 2019 and decreased by 50.2% (95% CI, -55.3 to -44.6; P < 0.001) in 2020, whereas there was no yearly change in research payments. Conclusions: Nearly 90% of pulmonologists received nonresearch and research payments from the healthcare industry in the United States. Nonresearch payments have been increasing since the inception of the Open Payments database.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Japan
| | - Hinari Kugo
- School of Medicine, Tohoku University, Sendai, Japan
| | - Yoshika Saito
- Medical Governance Research Institute, Minato-ku, Japan
- Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Japan
- Department of Internal Medicine, Soma Central Hospital, Soma, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Japan
- Department of Internal Medicine, Navitas Clinic Tachikawa, Tachikawa, Japan; and
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki, Japan
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8
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Murayama A, Hirota S. Industry payments to pathologists in the USA between 2013 and 2021. J Clin Pathol 2023; 76:566-570. [PMID: 37085323 DOI: 10.1136/jcp-2023-208901] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/23/2023]
Abstract
Although proper physician-industry financial relationships are essential for improving patient care, they can also cause potential conflicts of interest. However, little is known about the pathologist-industry financial relationships. Using the 2013-2021 Open Payments Database, this cross-sectional study investigated both research and non-research payments to all pathologists in the USA. Payment data were analyzed descriptively. Of 21,664 pathologists, 49.5% of all pathologists have received payments totaling $356.7 million from the healthcare industry, of which 68.2% were research payments. Median per-physician general and associated research payments (IQR) were $145($49-$575) and $70,926 ($17,450-$299,285) over the nine years. The top 1% of pathologists receiving general payments received 68.0% of all general payments. Male pathologists specializing in blood banking and transfusion medicine and hematopathology are significantly more likely than those not to receive research and non-research payments. This first study provides valuable insights into the financial relationships between pathologists and the healthcare industry.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Shuto Hirota
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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Powell K, Kakkilaya A, Haslam A, Prasad V. Financial Conflicts of Interest of OncoAlert: An Informal Oncology Professional Network. J Cancer Policy 2022; 34:100369. [DOI: 10.1016/j.jcpo.2022.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
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10
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Kusumi E, Murayama A, Kamamoto S, Kawashima M, Yoshida M, Saito H, Sawano T, Yamashita E, Tanimoto T, Ozaki A. Pharmaceutical payments to Japanese certified hematologists: a retrospective analysis of personal payments from pharmaceutical companies between 2016 and 2019. Blood Cancer J 2022; 12:54. [PMID: 35393417 PMCID: PMC8989935 DOI: 10.1038/s41408-022-00656-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Eiji Kusumi
- Department of Internal Medicine, Navitas Clinic Shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan. .,Tohoku University School of Medicine, Sendai City, Miyagi, Japan.
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Moe Kawashima
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Makoto Yoshida
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai City, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa City, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
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Pokorny AMJ, Moynihan R, Fox P, Karikios DJ, Bero LA, Mintzes BJ. Australian Cancer Physicians and the Pharmaceutical Industry: A Survey of Attitudes and Interactions. JCO Oncol Pract 2022; 18:e1154-e1163. [PMID: 35316090 DOI: 10.1200/op.21.00767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Interactions between cancer physicians and the pharmaceutical industry may create conflicts of interest that can adversely affect patient care. We aimed to survey cancer physicians regarding their attitudes toward and interactions with industry. METHODS We surveyed Australian cancer physicians between December 2020 and February 2021, questioning how often they interacted with industry and their attitudes toward this. We also assessed factors associated with accepting payments from industry and the amount received, and opinions on policies and industry influence. We used logistic and linear regression to examine links between attitudes and behaviors. RESULTS There were 116 responses (94 complete). Almost half (n = 53 of 115, 46.1%) felt that there was a positive relationship between cancer physicians and industry. Most (n = 79 of 104, 76.0%) interacted with industry at least once a month, and 67.7% (n = 63 of 93) had received nonresearch payments from industry previously, with a median value of 2,000 Australian dollars over 1 year. Most respondents believed that interactions could influence prescribing while simultaneously denying influence on their own prescribing (n = 66 of 94, 70.2%). Those who judged general sales representative interactions (odds ratio [OR] 9.37 [95% CI, 1.05 to 83.41], P = .045) or clinician sponsorship (OR 3.22 [95% CI, 1.01 to 10.30], P = .049) to be more acceptable also met with sales representatives more frequently. Physicians were more likely to accept industry payments when they deemed sponsorship of clinicians for conferences (OR 10.55 [95% CI, 2.33 to 47.89], P = .002) or honoraria for advisory board membership more acceptable (OR 3.91 [95% CI, 1.04 to 14.74], P = .04) or when they had higher belief in industry influence over own prescribing (OR 25.51 [95% CI, 2.70 to 241.45], P = .005). CONCLUSION Australian cancer physicians interact with industry frequently, and those who feel positive about these interactions are likely to do so more often. More research is needed to understand the motivations behind these interactions.
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Affiliation(s)
- Adrian M J Pokorny
- Alice Springs Hospital, Northern Territory, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ray Moynihan
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Peter Fox
- Central West Cancer Care Centre, Orange, New South Wales, Australia.,School of Medicine, Western Sydney University, New South Wales, Australia
| | - Deme J Karikios
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Nepean Cancer Care Centre, Kingswood, New South Wales, Australia
| | - Lisa A Bero
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Barbara J Mintzes
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Interactions with the pharmaceutical industry and the practice, knowledge and beliefs of medical oncologists and clinical haematologists: a systematic review. Br J Cancer 2022; 126:144-161. [PMID: 34599297 PMCID: PMC8727671 DOI: 10.1038/s41416-021-01552-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 08/23/2021] [Accepted: 09/15/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND No previous review has assessed the extent and effect of industry interactions on medical oncologists and haematologists specifically. METHODS A systematic review investigated interactions with the pharmaceutical industry and how these might affect the clinical practice, knowledge and beliefs of cancer physicians. MEDLINE, Embase, PsycINFO and Web of Science Core Collection databases were searched from inception to February 2021. RESULTS Twenty-nine cross-sectional and two cohort studies met the inclusion criteria. These were classified into three categories of investigation: (1) extent of exposure to industry for cancer physicians as whole (n = 11); (2) financial ties among influential cancer physicians specifically (n = 11) and (3) associations between industry exposure and prescribing (n = 9). Cancer physicians frequently receive payments from or maintain financial ties with industry, at a prevalence of up to 63% in the United States (US) and 70.6% in Japan. Among influential clinicians, 86% of US and 78% of Japanese oncology guidelines authors receive payments. Payments were associated with either a neutral or negative influence on the quality of prescribing practice. Limited evidence suggests oncologists believe education by industry could lead to unconscious bias. CONCLUSIONS There is substantial evidence of frequent relationships between cancer physicians and the pharmaceutical industry in a range of high-income countries. More research is needed on clinical implications for patients and better management of these relationships. REGISTRATION PROSPERO identification number CRD42020143353.
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Rahman MW, Trivedi NU, Bach PB, Mitchell AP. Increasing Financial Payments From Industry to Medical Oncologists in the United States, 2014-2017. J Natl Compr Canc Netw 2021; 20:jnccn20125. [PMID: 34965511 PMCID: PMC9309756 DOI: 10.6004/jnccn.2021.7024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 02/02/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Personal payments from the pharmaceutical industry to US physicians are common and are associated with changes in physicians' clinical practice and interpretation of clinical trial results. We assessed temporal trends in industry payments to oncologists, with particular emphasis on payments to authors of oncology clinical practice guideline and on payments related to immunotherapy drugs. METHODS We included US physicians with active National Plan and Provider Enumeration System records and demographic data available in the Centers for Medicare & Medicaid Services Physician Compare system who had a specialty type of medical oncology or general internal medicine. Medical oncologists serving on NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panels were identified manually. Industry payments, and the subset associated with PD-1/PD-L1 drugs, were identified in Open Payments, the federal repository of all transactions of financial value from industry to physicians and teaching hospitals, from 2014 to 2017. RESULTS There were 13,087 medical oncologists and 85,640 internists who received payments. The mean, annual, per-physician value of payments to oncologists increased from $3,811 in 2014 to $5,854 in 2017, and from $444 to $450 for internists; the median payment increased from $152 to $199 for oncologists and remained at $0 for internists. Oncologists who served on NCCN Guidelines Panels received a greater value in payments and experienced a greater relative increase: mean payments increased from $10,820 in 2014 to $18,977 in 2017, and median payments increased from $500 to $1,366. Among companies marketing PD-1/PD-L1 drugs, mean annual per-oncologist payments associated with PD-1/PD-L1 drugs increased from $28 to $773. Total per-oncologist payments from companies marketing PD-1/PD-L1 drugs experienced a 165% increase from 2014 to 2017, compared with a 31% increase among similar companies not marketing PD-1/PD-L1 drugs. CONCLUSIONS Pharmaceutical industry payments increased for US oncologists from 2014 to 2017 more than for general internists. The increase was greater among oncologists contributing to clinical practice guidelines and among pharmaceutical companies marketing PD-1/PD-L1 drugs. The increasing flow of money from industry to US oncologists supports ongoing concern regarding commercial interests in guideline development and clinical decision-making.
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Affiliation(s)
- Mohammed W Rahman
- 1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Niti U Trivedi
- 1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peter B Bach
- 1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Aaron P Mitchell
- 1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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Lexchin J, Fugh-Berman A. A Ray of Sunshine: Transparency in Physician-Industry Relationships Is Not Enough. J Gen Intern Med 2021; 36:3194-3198. [PMID: 33694070 PMCID: PMC8481515 DOI: 10.1007/s11606-021-06657-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/08/2021] [Indexed: 11/25/2022]
Abstract
Gifts from pharmaceutical and medical device companies to physicians in the United States have been reported since 2014, through the Physician Payments Sunshine Act. Although researchers have utilized these data to publish many studies on conflicts of interest (COIs) and prescribing behavior, there is no evidence that physician behavior regarding COI has changed, or that employers, meeting organizers, or medical journals are excluding physicians based on conflicts of interest. Disclosure is necessary but not sufficient to address the damage that industry relationships causes to medical knowledge and public health.
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Affiliation(s)
- Joel Lexchin
- School of Health Policy and Management, York University, Toronto, ON Canada
- University Health Network, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Adriane Fugh-Berman
- Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC USA
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15
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Durán CE, Cañás M, Urtasun M, Elseviers M, Vander Stichele R, Christiaens T. Potential negative impact of reputed regulators' decisions on the approval status of new cancer drugs in Latin American countries: A descriptive analysis. PLoS One 2021; 16:e0254585. [PMID: 34255795 PMCID: PMC8277058 DOI: 10.1371/journal.pone.0254585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/29/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Many new cancer drugs are being approved by reputed regulatory authorities without evidence of overall survival benefit, quality of life improvement, and often based on clinical trials at high risk of bias. In recent years, most Latin American (LA) countries have reformed their marketing authorization (MA) rules to directly accept or abbreviate the approval process in case of earlier authorization by the European Medicines Agency (EMA) and the US Food and Drug Administration, mainly. This study assessed the potential impact of decisions taken by EMA regarding the approval of new cancer drugs based on no evidence of overall survival or in potentially biased clinical trials in LA countries. DESIGN Descriptive analysis. SETTING Publicly accessible marketing authorization databases from LA regulators, European Public Assessment Report by EMA, and previous studies accessing EMA approvals of new cancer drugs 2009-2016. MAIN OUTCOME AND MEASURES Number of new cancer drugs approved by LA countries without evidence of overall survival (2009-2013), and without at least one clinical trial scored at low risk of bias, or with no trial supporting the marketing authorization at all (2014-2016). RESULTS Argentina, Brazil, Chile, Colombia, Ecuador, Panama and Peru have publicly accessible and trustful MA databases and were included. Of the 17 cancer drugs approved by EMA (2009-2013) without evidence of OS benefit after a postmarketing median time of 5.4 years, 6 LA regulators approved more than 70% of them. Of the 13 drugs approved by EMA (2014-2016), either without supporting trial or with no trial at low risk of bias, Brazil approved 11, Chile 10, Peru 10, Argentina 10, Colombia 9, Ecuador 9, and Panama 8. CONCLUSIONS LA countries keep approving new cancer drugs often based on poorly performed clinical trials measuring surrogate endpoints. EMA and other reputed regulators must be aware that their regulatory decisions might directly influence decisions regarding MA, health budgets and patient's care elsewhere.
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Affiliation(s)
- Carlos E. Durán
- Clinical Pharmacology Research Group, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Martín Cañás
- Federación Médica de la Provincia de Buenos Aires, La Plata, Argentina
- Instituto de Ciencias de la Salud, Universidad Nacional Arturo Jauretche, Florencio Varela, Argentina
| | - Martín Urtasun
- Federación Médica de la Provincia de Buenos Aires, La Plata, Argentina
- Instituto de Ciencias de la Salud, Universidad Nacional Arturo Jauretche, Florencio Varela, Argentina
| | - Monique Elseviers
- Clinical Pharmacology Research Group, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Robert Vander Stichele
- Clinical Pharmacology Research Group, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Thierry Christiaens
- Clinical Pharmacology Research Group, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
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16
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Marshall DC, Tarras ES, Chimonas S. Industry Payments to Medical Oncologists-Reply. JAMA Oncol 2021; 7:1073-1074. [PMID: 34042942 DOI: 10.1001/jamaoncol.2021.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Susan Chimonas
- Memorial Sloan Kettering Cancer Center, New York, New York
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17
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Industry payments to US physicians for cancer therapeutics: An analysis of the 2016–2018 open payments datasets. J Cancer Policy 2021; 28:100283. [DOI: 10.1016/j.jcpo.2021.100283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 11/19/2022]
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18
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Bagaria SP, Sabel M. Disclosure slide at the Society of Surgical Oncology Annual Symposium-Is there room for improvement? J Surg Oncol 2021; 123:1677-1678. [PMID: 33866569 DOI: 10.1002/jso.26502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Sanjay P Bagaria
- Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA.,Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Mike Sabel
- Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA.,Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
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19
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Tarras ES, Marshall DC, Rosenzweig K, Korenstein D, Chimonas S. Trends in Industry Payments to Medical Oncologists in the United States Since the Inception of the Open Payments Program, 2014 to 2019. JAMA Oncol 2021; 7:440-444. [PMID: 33377904 DOI: 10.1001/jamaoncol.2020.6591] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Given the potential for undue influence of industry-physician payments on oncology care, it is important to understand how a national transparency program may be associated with financial interactions between industry and medical oncologists. Objective To identify trends in industry payments to medical oncologists from 2014 to 2019 and determine if the implementation of the Open Payments program is associated with changes in the frequency or value of payments or any shift in the nature of industry-oncologist financial interactions. Design, Setting, and Participants This retrospective, population-based, observational cohort study analyzed Open Payments reports of industry payments made in 2014 to 2019 to a cohort of licensed medical oncologists practicing in the US in 2014, using data from the National Plan and Provider Enumeration System. Exposures Receipt of an industry payment from January 1, 2014, to December 31, 2019. Main Outcomes and Measures General industry payments to medical oncologists, including the proportion receiving payments, total annual value and number of payments, and average annual trends over time, by aggregate value and by nature-of-payment category. Trends over time were analyzed using linear regression and generalized estimating equations. Results In 2014 to 2019, there were 15 585 medical oncologists who received a total of 2.2 million industry payments with a total value of $509 million. The absolute number of oncologists receiving payments decreased from 10 498 in 2014 to 8918 in 2019 (-15.1%). The annual per-physician payment value decreased among those receiving less than $10 000 in aggregate by -3.2% yearly (95% CI, -4.1% to -2.3%; P < .001), but increased for those receiving more than $10 000. Payments increased for consulting (13.7%; 95% CI, 12.4%-15.0%; P < .001) and for entertainment, meals, travel or lodging, and gifts (0.8%; 95% CI, 0.1%-1.5%; P = .03). Conclusions and Relevance The number of medical oncologists accepting industry payments has decreased; however, high-value industry payments have been consolidated in a relatively small number of medical oncologists accepting higher payment values over time. The nature of payments has shifted toward consulting. These findings highlight the limitations of transparency without accountability.
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Affiliation(s)
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kenneth Rosenzweig
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Susan Chimonas
- Memorial Sloan Kettering Cancer Center, New York, New York
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20
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Royce TJ, Gupta GP, Chera BS. Increasing Nonresearch-Related Industry Funding in Radiation Oncology: Cause for Concern? Int J Radiat Oncol Biol Phys 2021; 109:26-28. [PMID: 33308695 DOI: 10.1016/j.ijrobp.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Trevor J Royce
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Gaorav P Gupta
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Bhisham S Chera
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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21
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Gangireddy VGR, Amin R, Yu K, Kanneganti P, Talla S, Annapureddy A. Analysis of payments to GI physicians in the United States: Open payments data study. JGH OPEN 2020; 4:1031-1036. [PMID: 33319034 PMCID: PMC7731803 DOI: 10.1002/jgh3.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/07/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022]
Abstract
Background and Aim The purpose of this study was to review and analyze the nature of industry payments to gastroenterology and hepatology (GI) physicians. Methods We conducted a retrospective study of open payments (OP) data for the year 2017. Payments to individual physicians were aggregated using a unique physician profile identification number. General payments to Centers for Medicare and Medicaid Services regions were also analyzed. The nature of financial transactions in general payments was reported overall and per physician payment. Research, ownership, and general payments were aggregated and analyzed by drug/device companies. Results During the study period, more GI physicians received contributions in the form of general payments compared to ownership or research payments. A small percentage of physicians received contributions greater than $100 000. The most frequent contributions were for food and beverages. Only 10 manufacturers made about 71% ($43 271 938) of general payments. Conclusions We found that only a small number of GI physicians received a significant portion of industry payments. A large portion of those payments came from drug or device companies. The impact of these payments on gastroenterologists needs to be examined further.
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Affiliation(s)
| | - Rajan Amin
- Department of Internal Medicine University of Texas Health Science Center at Houston Houston Texas USA
| | - Kevin Yu
- Department of Internal Medicine University of Texas Health Science Center at Houston Houston Texas USA
| | | | - Swathi Talla
- United Hospital Center West Virginia University Bridgeport West Virginia USA
| | - Amarnath Annapureddy
- Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA
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22
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Marshall DC, Tarras ES, Rosenzweig K, Yom SS, Hattangadi-Gluth J, Murphy J, Korenstein D, Chimonas S. Trends in Financial Relationships Between Industry and Radiation Oncologists Versus Other Physicians in the United States from 2014 to 2018. Int J Radiat Oncol Biol Phys 2020; 109:15-25. [PMID: 32858112 DOI: 10.1016/j.ijrobp.2020.08.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/01/2020] [Accepted: 08/18/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The Open Payments transparency program publishes data on industry-physician payments, in part to discourage relationships considered inappropriate including gifts, meals, and speaker's bureau fees. We evaluated trends in physician-level payments to test whether implementation of Open Payments resulted in fewer industry-radiation oncologist (RO) interactions or shifted interactions toward those considered more appropriate compared with medical oncologists (MOs) and other hospital-based physicians (HBPs). METHODS AND MATERIALS We performed a retrospective, population-based cohort study of practicing US ROs versus MOs and HBPs in 2014 matched to general (nonresearch) payments between 2014 and 2018. Trends in payments were analyzed and reported by nature of payment. Values of payments to ROs from the top 10 companies were identified. RESULTS From 2014 to 2018, 3379 (90.3%) ROs accepted 106,930 payments totaling $40.8 million. The per-physician number and value of payments was lower in radiation oncology than in medical oncology and higher than HBPs. The proportion of ROs accepting payments increased from 61.8% in 2014 to 64.2% in 2018; the proportion of MOs accepting payments decreased from 78.7% to 77.7%; and the proportion of HBPs decreased from 40.8% to 37.5%, respectively. The annual per-physician value and number of payments accepted by ROs and MOs increased. Payments in entertainment, meals, travel and lodging, and gifts increased among ROs and remained stable or decreased among MOs and HBPs. Consulting payments increased across all groups. Top RO payors produced novel cancer therapeutics, hydrogel spacers, radiation treatment machines, and opioids. CONCLUSIONS Industry payments to ROs have become more common since OP's inception, while becoming less common for MOs and HBPs. Payments to ROs and MOs have become more frequent and of modestly increasing value compared with other HBPs, for whom the value is decreasing. No large changes in the nature of relationships were seen in ROs. Increased engagement with financial conflicts of interest is needed in radiation oncology.
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Affiliation(s)
| | | | | | - Sue S Yom
- University of California San Francisco, San Francisco, California
| | | | - James Murphy
- University of California San Diego, San Diego, California
| | | | - Susan Chimonas
- Memorial Sloan Kettering Cancer Center, New York, New York
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23
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Pokorny AMJ, Bero LA, Moynihan R, Mintzes BJ. Industry payments to Australian medical oncologists and clinical haematologists: a cross-sectional analysis of publicly available disclosures. Intern Med J 2020; 51:1816-1824. [PMID: 32744396 DOI: 10.1111/imj.15005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/12/2020] [Accepted: 07/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Payments to medical oncologists and clinical haematologists can negatively affect prescribing practice, but the extent of payments to these specialists is unknown in Australia. AIMS To analyse the extent of payments from the pharmaceutical industry to Australian cancer physicians as reported during the first collated period of the Disclosure Australia website. METHODS We performed a retrospective, cross-sectional analysis of payments made from November 2018 to April 2019, using a file downloaded from the Disclosure Australia website. We checked the names of listed medical practitioners against Medical Board of Australia records to assign specialties. The number of medical oncologists, clinical haematologists, other specialist physicians and non-specialist physician medical practitioners was calculated, along with the payments to each of these groups. RESULTS A total of A$7 332 407 was paid to 2775 medical practitioners. Of these, 236 were medical oncologists, 189 were haematologists and 1145 were other specialist physicians. This represents 31.7% of Australian medical oncologists and 30.9% of Australian haematologists, compared with 11.7% of all other specialist physicians and 1.1% of all other non-specialist physician medical practitioners. Medical oncologists received significantly higher payments (median A$2131.26) than other specialist physicians (median A$1376.00, 2-tailed P = 0.004) and other medical practitioners (median A$709.00, 2-tailed P < 0.001), while haematologists received significantly higher payments (median A$1519.95) than other medical practitioners (2-tailed P < 0.001), but similar payments to other specialist physicians (2-tailed P = 0.08). CONCLUSIONS Australian cancer physicians receive payments at a higher proportional frequency and in greater dollar amounts than other specialist physicians and other medical practitioners in general.
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Affiliation(s)
- Adrian M J Pokorny
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Medical Oncology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Lisa A Bero
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Raymond Moynihan
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Barbara J Mintzes
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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24
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Katz MS, Anderson PF, Thompson MA, Salmi L, Freeman-Daily J, Utengen A, Dizon DS, Blotner C, Cooke DT, Sparacio D, Staley AC, Fisch MJ, Young C, Attai DJ. Organizing Online Health Content: Developing Hashtag Collections for Healthier Internet-Based People and Communities. JCO Clin Cancer Inform 2020; 3:1-10. [PMID: 31251658 DOI: 10.1200/cci.18.00124] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twitter use has increased among patients with cancer, advocates, and oncology professionals. Hashtags, a form of metadata, can be used to share content, organize health information, and create virtual communities of interest. Cancer-specific hashtags modeled on a breast cancer community, #bcsm, led to the development of a structured set of hashtags called the cancer tag ontology. In this article, we review how these hashtags have worked with the aim of describing our experience from 2011 to 2017. We discuss useful guidelines for the development and maintenance of health-oriented communities on Twitter, including possible challenges to community sustainability and opportunities for future improvement and research.
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Affiliation(s)
| | | | | | - Liz Salmi
- Beth Israel Deaconess Medical Center, Boston, MA.,Brain Cancer Quality of Life Collaborative, Sacramento, CA
| | | | | | | | | | - David T Cooke
- University of California Davis Medical Center, Sacramento, CA
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25
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Pace NM, Maganty A, Siripong N, Lee AJ, Huang D, Bandari J, Jacobs BL, Davies BJ. Gender Gap in Industry Relationships and Scholarly Impact Among Academic Urologists in the United States. Urology 2020; 139:90-96. [DOI: 10.1016/j.urology.2020.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/09/2020] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
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26
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Haque W, Alvarenga M, Hsiehchen D. Nonresearch Pharmaceutical Industry Payments to Oncology Physician Editors. Oncologist 2020; 25:e986-e989. [PMID: 32272494 DOI: 10.1634/theoncologist.2019-0828] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/16/2020] [Indexed: 12/15/2022] Open
Abstract
Journal editors are gatekeepers of knowledge, and pharmaceutical industry payments to oncology editors have not been previously characterized. We performed a cross-sectional study of nonresearch industry payments to editors of 26 oncology research journals. A total of 433 editors were eligible for inclusion in the CMS Open Payments database from 2013 to 2018. A total of 80% of eligible editors had nonresearch payments, and the mean value of payments per editor was $106,778, which has increased over time. Only 5 out of 26 journals disclosed editor conflicts of interest and 3 of these journals reported at least one editor with no nonresearch industry payments but were found to have nonresearch payments. There was a positive correlation between journal impact factor and the average payment per editor for each journal. Our study shows the high prevalence and lack of transparency of nonresearch industry payments to oncology editors. Higher impact journals appear to be associated with greater nonresearch industry payments.
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Affiliation(s)
- Waqas Haque
- Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maria Alvarenga
- University of Texas Health Rio Grande Valley School of Medicine, Dallas, Texas, USA
| | - David Hsiehchen
- Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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27
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Inoue K, Blumenthal DM, Elashoff D, Tsugawa Y. Association between physician characteristics and payments from industry in 2015-2017: observational study. BMJ Open 2019; 9:e031010. [PMID: 31542759 PMCID: PMC6756347 DOI: 10.1136/bmjopen-2019-031010] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the association between physician characteristics and the value of industry payments. DESIGN Observational study. SETTING AND PARTICIPANTS Using the 2015-2017 Open Payments reports of industry payments linked to the Physician Compare database, we examined the association between physician characteristics (physician sex, years in practice, medical school attended and specialty) and the industry payment value, adjusting for other physician characteristic and institution fixed effects (effectively comparing physicians practicing at the same institution). MAIN OUTCOME MEASURES Our primary outcome was the value of total industry payments to physicians including (1) general payments (all forms of payments other than those classified for research purpose, eg, consulting fees, food, beverage), (2) research payments (payments for research endeavours under a written contract or protocol) and (3) ownership interests (eg, stock or stock options, bonds). We also investigated each category of payment separately. RESULTS Of 544 264 physicians treating Medicare beneficiaries, a total of $5.8 billion in industry payments were made to 365 801 physicians during 2015-2017. The top 5% of physicians, by cumulative payments, accounted for 91% of industry payments. Within the same institution, male physicians, physicians with 21-30 years in practice and physicians who attended top 50 US medical schools (based on the research ranking) received higher industry payments. Across specialties, orthopaedic surgeons, neurosurgeons and endocrinologists received the highest payments. When we investigated individual types of payment, we found that orthopaedic surgeons received the highest general payments; haematologists/oncologists were the most likely to receive research payments and surgeons were the most likely to receive ownership interests compared with other types of physicians. CONCLUSIONS Industry payments to physicians were highly concentrated among a small number of physicians. Male sex, longer length of time in clinical practice, graduated from a top-ranked US medical school and practicing certain specialties, were independently associated with higher industry payments.
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Affiliation(s)
- Kosuke Inoue
- Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Daniel M Blumenthal
- Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Devoted Health, Waltham, Massachusetts, USA
| | - David Elashoff
- Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Department of Medicine Statistics Core, UCLA David Geffen School of Medicine, Los Angeles, California, USA
- General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Yusuke Tsugawa
- General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California, USA
- Department of Health Policy Management, UCLA Fielding School of Public Health, Los Angeles, California, USA
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28
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Ahlawat A, Narayanaswami P. Financial relationships between neurologists and industry. Neurology 2019; 92:1006-1013. [DOI: 10.1212/wnl.0000000000007640] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/04/2019] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo analyze research and nonresearch payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services (CMS) Open Payments Database.MethodsIn this retrospective database analysis, we computed the percentage of neurologists in the United States receiving payments, the median/mean payments per neurologist, payment categories, regional trends, and sponsors. We computed the number of practicing neurologists from the Association of American Medical Colleges State Physician Workforce Data Book, 2015.ResultsIn 2015, approximately 96% of US neurologists received nonresearch payments totaling $93,920,993. The median payment per physician was $407. The highest proportion of neurologists (24%) received between $1,000 and $10,000. Food and beverage was the most frequent category (83% of the total number of payments). The highest amount was paid for serving as faculty/speaker for noncontinuing medical education activities (49%). The top sponsor of nonresearch payments was Teva Pharmaceuticals ($16,461,055; 17.5%). A total of 412 neurologists received $2,921,611 in research payments (median $1,132). Multiple sclerosis specialists received the largest proportion ($285,537; 9.7%). Daiichi Sankyo paid the largest amount in research payments ($826,029; 28%).ConclusionsThe Open Payments program was established to foster transparent disclosure of physician compensations from industry, in response to legislative and public concerns of the effect of conflicts of interest on practice, education, and research. The effects of this program remain unclear and studies of changes in prescribing practices, costs, and other outcomes are necessary. CMS should ensure that incorrect information can be rectified quickly and easily.
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Weng JK, Valle LF, Nam GE, Chu FI, Steinberg ML, Raldow AC. Evaluation of Sex Distribution of Industry Payments Among Radiation Oncologists. JAMA Netw Open 2019; 2:e187377. [PMID: 30681710 PMCID: PMC6484553 DOI: 10.1001/jamanetworkopen.2018.7377] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Industry relationships are an important measure of professional advancement; however, the association between physician sex and industry payments in radiation oncology has not been described. OBJECTIVE To update the trends in the sex distribution of industry payments in radiation oncology. DESIGN, SETTING, AND PARTICIPANTS This retrospective cross-sectional study was conducted between July 1, 2018, and August 31, 2018. It used the publicly available Centers for Medicare & Medicaid Services (CMS) Open Payments program and CMS Physician and Other Supplier Public Use File databases to obtain 2016 industry payment data for US radiation oncologists who reported receiving industry funding in that year (n = 3052). Total monetary value, number of payments, and median payment amounts were determined for each sex in the following categories: research, consulting, honoraria, industry grants, royalty or license, and services other than consulting. MAIN OUTCOMES AND MEASURES Industry payment amounts among 3052 radiation oncologists who reported receiving payments in 2016; association of median payment with the types of payment by sex. RESULTS Of the total 4483 radiation oncologists who practiced in 2016, 1164 (25.9%) were female and 3319 (74.0%) were male. Industry payments were distributed among 3052 radiation oncologists (68.1%), of whom 715 (23.4%) were female and 2337 (76.6%) were male. The proportion of female radiation oncologists who received at least 1 industry payment was 61.4% (715 of 1164), whereas the proportion of their male counterparts was 70.4% (2337 of 3319). Across all payment types, female radiation oncologists received a smaller percentage of total industry funding than the percentage of female physicians represented in each category. The median payment value was smaller for female radiation oncologists in consulting (-$1000; 95% CI, -$1966.67 to $100.63; P = .005) and honoraria (-$500; 95% CI, -$1071.43 to $0; P = .007). This trend was also observed in research payments, but was not statistically significant (-$135.02; 95% CI, -$476.93 to $6.88; P = .08). Of the $1 347 509 royalty or license payments made to 72 physicians, none was for female radiation oncologists. CONCLUSIONS AND RELEVANCE Distribution of industry payments appears to show sex disparity in industry relationships among radiation oncologists; this observation warrants further investigation to determine the underlying reasons and provide avenues for increased parity.
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Affiliation(s)
- Julius K. Weng
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Luca F. Valle
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Gina E. Nam
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Fang-I Chu
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Michael L. Steinberg
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Ann C. Raldow
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
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Nusrat S, Syed T, Nusrat S, Chen S, Chen WJ, Bielefeldt K. Assessment of Pharmaceutical Company and Device Manufacturer Payments to Gastroenterologists and Their Participation in Clinical Practice Guideline Panels. JAMA Netw Open 2018; 1:e186343. [PMID: 30646328 PMCID: PMC6324539 DOI: 10.1001/jamanetworkopen.2018.6343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Payments from pharmaceutical and device manufacturers to physicians may influence the advice physicians give patients and peers. OBJECTIVES To investigate the nature and amounts of monetary and other benefits that gastroenterologists received and to determine the participation of those receiving benefits in the formulation of clinical practice guidelines. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed information from the Centers for Medicare & Medicaid Services Open Payments database, including all reports about payments that pharmaceutical and device manufacturers gave to adult or pediatric gastroenterologists in 2016. PubMed was used to examine the professional affiliations and publication records of top payment recipients. Panelists of clinical guidelines who also received personal financial rewards listed in the Open Payments database were identified. MAIN OUTCOMES AND MEASURES Payments made to gastroenterologists by pharmaceutical company and device manufacturers. RESULTS Of 15 497 gastroenterologists, 13 467 (86.9%) received a total of 432 463 payments accounting for a total expenditure of $67 144 862. Direct financial payments for consultations, talks, or other services were made to 2055 physicians and were responsible for 4.2% of payments (18 179 of 432 463), but for 62.7% of total expenditures ($42 086 207 of $67 144 862). Although a significant number of submissions were for food and beverages, they constituted only a small amount of total expenditure. For gastroenterologists treating adult patients, 10 products were linked to 63.8% of payments (11 221 of 17 588) related to direct financial rewards and 37.1% of the total expenditures ($24 892 643 of $67 144 862). Twenty-nine of 36 clinical practice guidelines included panelists who had received honoraria or consultation fees from industry sources, with amounts exceeding $10 000 in 8 of them (22%). CONCLUSIONS AND RELEVANCE Most gastroenterologists accept meals or gifts from industry, with 2055 of 15 497 gastroenterologists receiving direct payments and 8 of 36 clinical practice guidelines panelists having received more than $10 000. Considering the known impact of such benefits on prescribing patterns and other professional behaviors, policy makers should consider revising regulations governing interactions with industry and disclosure formats alerting others to their potential biasing impact.
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Affiliation(s)
- Salman Nusrat
- Section of Digestive Diseases and Nutrition, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
- Section of Digestive Diseases and Nutrition, Department of Medicine, Veterans Affairs Medical Center, Oklahoma City, Oklahoma
| | - Taseen Syed
- Section of Digestive Diseases and Nutrition, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
- Section of Digestive Diseases and Nutrition, Department of Medicine, Veterans Affairs Medical Center, Oklahoma City, Oklahoma
| | - Sanober Nusrat
- Section of Digestive Diseases and Nutrition, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
- Section of Digestive Diseases and Nutrition, Department of Medicine, Veterans Affairs Medical Center, Oklahoma City, Oklahoma
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City
| | - Wei-Jen Chen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City
| | - Klaus Bielefeldt
- Section of Gastroenterology, Department of Medicine, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
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Hayes MJ, Prasad V. Financial Conflicts of Interest at FDA Drug Advisory Committee Meetings. Hastings Cent Rep 2018; 48:10-13. [PMID: 29590518 DOI: 10.1002/hast.833] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The U.S. Food and Drug Administration's drug advisory committees provide expert assessments of the safety and efficacy of new therapies considered for approval. A committee hears from a variety of speakers, from six groups, including voting members of the committee, FDA staff members, employees of the pharmaceutical company seeking approval of a therapy, patient and consumer representatives, expert speakers invited by the company, and public participants. The committees convene at the request of the FDA when the risks and harms of novel products are not immediately clear, and their final decisions carry significant weight, as most therapies that receive advisory committee approval are subsequently approved by the FDA. In recent years, across a series of diverse publications, the financial conflicts of interest of each category of participants in the meetings have been investigated. Here, we summarize these findings and their ethical implications, focusing on the FDA Oncologic Drugs Advisory Committee, and we suggest ways to move toward more transparent and impartial advisory committee meetings.
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Brunt CS. Physician characteristics, industry transfers, and pharmaceutical prescribing: Empirical evidence from medicare and the physician payment sunshine act. Health Serv Res 2018; 54:636-649. [PMID: 30273976 DOI: 10.1111/1475-6773.13064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate physician characteristics associated with pharmaceutical industry transfers and prescribing behavior after public reporting under the Sunshine Act. DATA SOURCES 2014-2016 secondary data on industry transfers to physicians from the Open Payments Dataset supplemented with Medicare Part D prescription data, Medicare service data, and practice attributes from the Physician Compare Database. STUDY DESIGN Using regression analysis with county/physician fixed effects, this study examines characteristics associated with the probability/magnitude of transfers and the association between transfers and prescriptions. DATA COLLECTION Using an iterative matching approach, this study identifies physicians who delivered outpatient Medicare services in 2014 (n = 409 041) and tracks their annual transfers between 2014 and 2016 (N = 1 227 123) across six transfer categories. In addition, it examines their Medicare Part D prescription behavior between 2014 and 2015 (N = 741 659). PRINCIPAL FINDINGS Industry transfers dramatically declined in 2015 and 2016. Transfers are significantly associated with increased prescription costs, branded prescribing, and prescribing for High-Risk Medications (HRMs). CONCLUSIONS Industry transfers have declined after public reporting. Transfers are associated with higher prescription costs and incidence of HRMs. Future research is needed to determine the causal impact on quality and cost-effectiveness of prescribed medications.
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Ahmed AA, Yoo SK, Mehta S, Holliday EB, Deville C, Vapiwala N, Wilson LD, Jagsi R, Prasad V, Thomas CR. Meaningful and Accurate Disclosure of Conflict of Interest at the ASTRO National Meeting: A Need for Reassessment of Current Policies. J Oncol Pract 2018; 14:JOP1800121. [PMID: 30260714 DOI: 10.1200/jop.18.00121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
PURPOSE: Conflict of interest (COI) disclosure is essential to research integrity. The average reading comprehension in English is 3.8 words per second (wps). This study examines presenters at the American Society for Radiation Oncology (ASTRO) national meeting over a recent 3-year period to determine whether disclosure is presented accurately and in a manner that allows the audience to comprehend the content. METHODS: We examined videos of presentations as well as slides from 2014 to 2016 from the ASTRO virtual meeting, noting whether a COI slide was presented, the duration the slide was visible, and the number of disclosures. Disclosures were cross-referenced for discrepancies with the publicly reported Centers for Medicare and Medicaid Services Open Payments database. Using a cutoff of 4 wps, we noted how many presentations were presented at speeds of ≤ 4 wps and > 4 wps. RESULTS: The final data set consisted of 401 presentations delivered by 364 presenters. Using a threshold of 4 wps, 34.0% of presenters had COI slides shown too fast for the average audience to comprehend. Moreover, 16.3% of US physicians incorrectly underreported industry funding received. Of these presentations with discrepancies, 32.6% did not have a COI slide, 39.5% failed to disclose any COI, 27.9% partially disclosed COIs, and 11.6% contained multiple discrepancies. The number of wps were correlated with having a discrepancy on multivariable regression ( P = .046; odds ratio, 1.08; 95% CI, 1.01 to 1.19). CONCLUSION: A substantial minority of presentations at ASTRO lack meaningful disclosure, and a surprising number incorrectly reported COIs. Additional guidance may be needed to promote more meaningful and accurate disclosure of COIs at major national meetings in oncology.
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Affiliation(s)
- Awad A Ahmed
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Stella K Yoo
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Shahil Mehta
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Emma B Holliday
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Curtiland Deville
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Neha Vapiwala
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Lynn D Wilson
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Reshma Jagsi
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Vinay Prasad
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
| | - Charles R Thomas
- University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center; Jackson Memorial Hospital, Miami, FL; University of Southern California Keck School of Medicine, Los Angeles, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; Yale School of Medicine, New Haven, CT; University of Michigan, Ann Arbor, MI; and Oregon Health and Science University, Portland, OR
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DeCensi A, Numico G, Ballatori E, Artioli F, Clerico M, Fioretto L, Livellara V, Ruggeri B, Tomirotti M, Verusio C, Roila F. Conflict of interest among Italian medical oncologists: a national survey. BMJ Open 2018; 8:e020912. [PMID: 29961019 PMCID: PMC6042593 DOI: 10.1136/bmjopen-2017-020912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/03/2018] [Accepted: 05/04/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To assess Italian medical oncologists' opinion on the implications of conflict of interest (COI) on medical education, care and research, and to evaluate their direct financial relationships. DESIGN National cross-sectional survey conducted between March and April 2017 among Italian oncologists. SETTING Online survey sponsored by the Italian College of Medical Oncology Chiefs through its website. PARTICIPANTS Italian oncologists who filled out an anonymous questionnaire including 19 items and individual and working characteristics. MAIN OUTCOME MEASURE The proportion of medical oncologists perceiving COI as an outstanding issue and those receiving direct payments from industry. RESULTS There were 321 respondents, representing 13% of Italian tenured medical oncologists. Overall, 62% declared direct payments from the pharmaceutical industry in the last 3 years. Sixty-eight per cent felt the majority of Italian oncologists have a COI with industry, but 59% suppose this is not greater than that of other specialties. Eighty-two per cent consider that most oncology education is supported by industry. More than 75% believe that current allocation of industry budget on marketing and promotion rather than research and development is unfair, but 75% consider it appropriate to receive travel and lodging hospitality from industry. A median net profit margin of €5000 per patient enrolled in an industry trial was considered appropriate for the employee institution. Sixty per cent agree to receive a personal fee for patients enrolled in industry trials, but 79% state this should be reported in the informed consent. Over 90% believe that scientific societies should publish a financial report of industry support. Finally, 79% disagree to being a coauthor of an article written by a medical writer when no substantial scientific contribution is made. CONCLUSIONS Among Italian oncologists COI is perceived as an important issue influencing costs, education, care and science. A more rigorous policy on COI should be implemented.
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Affiliation(s)
- Andrea DeCensi
- Division of Medical Oncology, Galliera Hospital, Genova, Italy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Gianmauro Numico
- Division of Medical Oncology, SS Antonio e Biagio Hospital, Alessandria, Italy
| | | | - Fabrizio Artioli
- Department of Oncology, Carpi and Mirandola Hospitals, Carpi e Mirandola, Italy
| | - Mario Clerico
- Department of Medical Oncology, Hospital of Biella, Biella, Italy
- CIPOMO, Milan, Italy
| | - Luisa Fioretto
- Department of Oncology, SM Annunziata Hospital, Florence, Italy
| | | | - Benedetta Ruggeri
- Clinical Governance, Area Vasta 5, ASUR Marche, Ascoli Piceno, Italy
| | | | - Claudio Verusio
- Division of Medical Oncology, ASST Valle Olona, Saronno, Italy
| | - Fausto Roila
- Division of Medical Oncology, Ospedale Santa Maria, Terni, Italy
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Kavanagh BD. Honor Was Never Lost: The National Farm Machinery Show and the American Society for Radiation Oncology Annual Meeting. Int J Radiat Oncol Biol Phys 2018; 101:259-260. [DOI: 10.1016/j.ijrobp.2018.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 11/28/2022]
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Ahlawat A, Narayanaswami P. Financial relationships between neurologists and industry: The 2015 Open Payments database. Neurology 2018; 90:1063-1070. [PMID: 29728521 DOI: 10.1212/wnl.0000000000005657] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/08/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To analyze research and nonresearch payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services (CMS) Open Payments database. METHODS In this retrospective database analysis, we computed the percentage of neurologists in the United States receiving payments, the median/mean payments per neurologist, payment categories, regional trends, and sponsors. We computed the number of practicing neurologists from the Association of American Medical Colleges State Physician Workforce data book, 2015. RESULTS In 2015, approximately 51% of US neurologists received nonresearch payments totaling $6,210,414. The median payment per physician was $81. Payments to the top 10% of compensated neurologists amounted to $5,278,852 (84.5%). Food and beverage was the most frequent category (86.5% of the total number of payments). The highest amount was paid for serving as faculty/speaker for noncontinuing medical education activities (58%). The top sponsor of nonresearch payments was Teva Pharmaceuticals ($1,162,900; 18.5%). A total of 412 neurologists received $2,921,611 in research payments (median $1,132). Multiple sclerosis specialists received the largest proportion ($285,537; 9.7%). Daiichi Sankyo paid the largest amount in research payments ($826,029; 28%). CONCLUSIONS The Open Payments program was established to foster transparent disclosure of physician compensation from industry, in response to legislative and public concerns over the effect of conflicts of interest on practice, education, and research. The effects of this program remain unclear and studies of changes in prescribing practices, costs, and other outcomes are necessary. CMS should ensure that incorrect information can be rectified quickly and easily.
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Affiliation(s)
- Aditi Ahlawat
- From the Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Pushpa Narayanaswami
- From the Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
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Piper BJ, Lambert DA, Keefe RC, Smukler PU, Selemon NA, Duperry ZR. Undisclosed conflicts of interest among biomedical textbook authors. AJOB Empir Bioeth 2018; 9:59-68. [PMID: 29400625 DOI: 10.1080/23294515.2018.1436095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Textbooks are a formative resource for health care providers during their education and are also an enduring reference for pathophysiology and treatment. Unlike the primary literature and clinical guidelines, biomedical textbook authors do not typically disclose potential financial conflicts of interest (pCoIs). The objective of this study was to evaluate whether the authors of textbooks used in the training of physicians, pharmacists, and dentists had appreciable undisclosed pCoIs in the form of patents or compensation received from pharmaceutical or biotechnology companies. METHODS The most recent editions of six medical textbooks, Harrison's Principles of Internal Medicine (HarPIM), Katzung and Trevor's Basic and Clinical Pharmacology (KatBCP), the American Osteopathic Association's Foundations of Osteopathic Medicine (AOAFOM), Remington: The Science and Practice of Pharmacy (RemSPP), Koda-Kimble and Young's Applied Therapeutics (KKYAT), and Yagiela's Pharmacology and Therapeutics for Dentistry (YagPTD), were selected after consulting biomedical educators for evaluation. Author names (N = 1,152, 29.2% female) were submitted to databases to examine patents (Google Scholar) and compensation (ProPublica's Dollars for Docs [PDD]). RESULTS Authors were listed as inventors on 677 patents (maximum/author = 23), with three-quarters (74.9%) to HarPIM authors. Females were significantly underrepresented among patent holders. The PDD 2009-2013 database revealed receipt of US$13.2 million, the majority to (83.9%) to HarPIM. The maximum compensation per author was $869,413. The PDD 2014 database identified receipt of $6.8 million, with 50.4% of eligible authors receiving compensation. The maximum compensation received by a single author was $560,021. Cardiovascular authors were most likely to have a PDD entry and neurologic disorders authors were least likely. CONCLUSION An appreciable subset of biomedical authors have patents and have received remuneration from medical product companies and this information is not disclosed to readers. These findings indicate that full transparency of financial pCoI should become a standard practice among the authors of biomedical educational materials.
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Affiliation(s)
- Brian J Piper
- a Neuroscience Program, Bowdoin College.,b Department of Basic Sciences , Geisinger Commonwealth School of Medicine
| | - Drew A Lambert
- c Department of Pharmacy Practice , Husson University School of Pharmacy
| | | | | | - Nicolas A Selemon
- e Department of Biology , Bowdoin College.,f Complex Joint Reconstruction Center, Hospital for Special Surgery
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Kaestner V, Edmiston JB, Prasad V. The relation between publication rate and financial conflict of interest among physician authors of high-impact oncology publications: an observational study. CMAJ Open 2018; 6:E57-E62. [PMID: 29382668 PMCID: PMC5878961 DOI: 10.9778/cmajo.20170095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Despite the abundant research on financial conflict of interest regarding provider behaviour and the interpretation and results of research, little is known about the relation between these conflicts in academia and the trajectory of one's academic career. We performed a study to examine whether the presence of financial ties to drug makers among academics is associated with research productivity. METHODS We hand-searched 3 high-impact general medical journals (New England Journal of Medicine, JAMA and The Lancet) and 3 high-impact oncology journals that publish original science (The Lancet Oncology, Journal of Clinical Oncology and Journal of the National Cancer Institute) to identify physicians based in the United States who were first or last authors on original papers on hematologic or oncologic topics that appeared in 2015. We ascertained their publication history from Scopus and their personal and research payments from the Centers for Medicare & Medicaid Services' Open Payments Web site (2013-2015). The strength of association between general (personal) financial payments from 2013 to 2015 and publications from 2013 to 2016 was determined by multivariate regression. RESULTS Our sample consisted of 435 physicians who had authored a median of 140 publications, earning a median h-index of 36 and a median of 5639 citations. The median total of general payments from 2013 to 2015 was US$3282 (range $0-$3.4 million), and the median amount of research payments was US$3500 (range $0-$23 million). General payments were associated with contemporary publications, with an increase of 1.99 papers (95% confidence interval [CI] 1.1 to 2.9) per $10 000 in payments. This association persisted in multivariate analysis after adjustment for prior publications, seniority and research payments (0.84 papers [95% CI 0.15 to 1.5] per $10 000 in payments). INTERPRETATION The findings suggest that there is a positive association between personal payments from drug makers and publications, and that this association persists after adjustment for prior publications, time since medical school graduation and research payments.
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Affiliation(s)
- Victoria Kaestner
- Affiliations: Division of Hematology and Medical Oncology (Kaestner, Prasad), Knight Cancer Institute, Oregon Health and Science University; School of Medicine (Edmiston), Oregon Health and Science University; Department of Preventive Medicine and Public Health (Prasad); Center for Health Care Ethics (Prasad), Oregon Health and Science University, Portland, Ore
| | - Jonathan B Edmiston
- Affiliations: Division of Hematology and Medical Oncology (Kaestner, Prasad), Knight Cancer Institute, Oregon Health and Science University; School of Medicine (Edmiston), Oregon Health and Science University; Department of Preventive Medicine and Public Health (Prasad); Center for Health Care Ethics (Prasad), Oregon Health and Science University, Portland, Ore
| | - Vinay Prasad
- Affiliations: Division of Hematology and Medical Oncology (Kaestner, Prasad), Knight Cancer Institute, Oregon Health and Science University; School of Medicine (Edmiston), Oregon Health and Science University; Department of Preventive Medicine and Public Health (Prasad); Center for Health Care Ethics (Prasad), Oregon Health and Science University, Portland, Ore
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Industry Funding Among Leadership in Medical Oncology and Radiation Oncology in 2015. Int J Radiat Oncol Biol Phys 2017; 99:280-285. [DOI: 10.1016/j.ijrobp.2017.01.202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 01/12/2017] [Accepted: 01/17/2017] [Indexed: 11/18/2022]
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Kaestner V, Prasad V. Job postings for biopharmaceutical industry in medical journals is 45-fold greater for hematology oncology than medical specialties. Blood Cancer J 2017; 7:e609. [PMID: 29016568 PMCID: PMC5637109 DOI: 10.1038/bcj.2017.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- V Kaestner
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - V Prasad
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.,Department of Preventive Medicine and Public Health, Oregon Health and Science University, Portland, OR, USA.,Center for Health Care Ethics, Oregon Health and Science University, Portland, OR, USA
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Tringale KR, Marshall D, Mackey TK, Connor M, Murphy JD, Hattangadi-Gluth JA. Types and Distribution of Payments From Industry to Physicians in 2015. JAMA 2017; 317:1774-1784. [PMID: 28464140 PMCID: PMC5470350 DOI: 10.1001/jama.2017.3091] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
IMPORTANCE Given scrutiny over financial conflicts of interest in health care, it is important to understand the types and distribution of industry-related payments to physicians. OBJECTIVE To determine the types and distribution of industry-related payments to physicians in 2015 and the association of physician specialty and sex with receipt of payments from industry. DESIGN, SETTING, AND PARTICIPANTS Observational, retrospective, population-based study of licensed US physicians (per National Plan & Provider Enumeration System) linked to 2015 Open Payments reports of industry payments. A total of 933 295 allopathic and osteopathic physicians. Outcomes were compared across specialties (surgery, primary care, specialists, interventionalists) and between 620 166 male (66.4%) and 313 129 female (33.6%) physicians using regression models adjusting for geographic Medicare-spending region and sole proprietorship. EXPOSURES Physician specialty and sex. MAIN OUTCOMES AND MEASURES Reported physician payment from industry (including nature, number, and value), categorized as general payments (including consulting fees and food and beverage), ownership interests (including stock options, partnership shares), royalty or license payments, and research payments. Associations between physician characteristics and reported receipt of payment. RESULTS In 2015, 449 864 of 933 295 physicians (133 842 [29.8%] women), representing approximately 48% of all US physicians were reported to have received $2.4 billion in industry payments, including approximately $1.8 billion for general payments, $544 million for ownership interests, and $75 million for research payments. Compared with 47.7% of primary care physicians (205 830 of 431 819), 61.0% of surgeons (110 604 of 181 372) were reported as receiving general payments (absolute difference, 13.3%; 95% CI, 13.1-13.6; odds ratio [OR], 1.72; P < .001). Surgeons had a mean per-physician reported payment value of $6879 (95% CI, $5895-$7862) vs $2227 (95% CI, $2141-$2314) among primary care physicians (absolute difference, $4651; 95% CI, $4014-$5288). After adjusting for geographic spending region and sole proprietorship, men within each specialty had a higher odds of receiving general payments than did women: surgery, 62.5% vs 56.5% (OR, 1.28; 95% CI, 1.26-1.31); primary care, 50.9% vs 43.0% (OR, 1.38; 95% CI, 1.36-1.39); specialists, 36.3% vs 33.4% (OR, 1.15; 95% CI, 1.13-1.17); and interventionalists, 58.1% vs 40.7% (OR, 2.03; 95% CI, 1.97-2.10; P < .001 for all tests). Similarly, men reportedly received more royalty or license payments than did women: surgery, 1.2% vs 0.03% (OR, 43.20; 95% CI, 25.02-74.57); primary care, 0.02% vs 0.002% (OR, 9.34; 95% CI, 4.11-21.23); specialists, 0.08% vs 0.01% (OR, 3.67; 95% CI, 1.71-7.89); and for interventionalists, 0.13% vs 0.04% (OR, 7.98; 95% CI, 2.87-22.19; P < .001 for all tests). CONCLUSIONS AND RELEVANCE According to data from 2015 Open Payments reports, 48% of physicians were reported to have received a total of $2.4 billion in industry-related payments, primarily general payments, with a higher likelihood and higher value of payments to physicians in surgical vs primary care specialties and to male vs female physicians.
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Affiliation(s)
| | - Deborah Marshall
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla
| | - Tim K. Mackey
- University of California, San Diego School of Medicine, Division of Global Public Health, Department of Anesthesiology, La Jolla
| | - Michael Connor
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla
| | - James D. Murphy
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla
| | - Jona A. Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla
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Verma V. Financial Relationships With Industry of Editorial Board Members of the Three Journals of the American Society for Radiation Oncology. Int J Radiat Oncol Biol Phys 2017; 99:286-291. [PMID: 28871971 DOI: 10.1016/j.ijrobp.2017.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 02/25/2017] [Accepted: 03/09/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To quantitate financial conflicts of interest (FCOIs) among radiation oncology peer-reviewers, specifically editorial board members of the 3 American Society for Radiation Oncology journals. METHODS AND MATERIALS The public Centers for Medicare and Medicaid Services Open Payments database delineates payments in 3 categories (general payments, research funding, and company ownership). After excluding non-US and non-MDs, names of board members were searched. Values of each FCOI were extracted for 2013 to 2015 and compiled. RESULTS Of 85 board members, 65 (76%) received any form of payment during the overall period. The majority of delivered payments were general payments: 59 (69%) received at least 1 general payment during these 3 years. In each year, 9 board members (11%) received research funding, and 3 board members (4%) reported company ownership. Over the studied period, all board members received a sum total of $5,387,985; this was composed of $665,801 (12%) in general payments, $3,758,968 (70%) in research funding, and $963,216 (18%) in company ownership. The mean general payment and research funding amounts (all members) were $2,621 and $14,741, respectively. Median (interquartile range) general payments and research funding only in board members receiving payments were $419 ($91-$5072) and $56,250 ($13,345-$200,000), respectively. When assessing general payments according to amount, the vast majority of editorial board members received lower-quantity or no such payments, along with a smaller proportion that received higher-volume payments. The most frequent sources of general payments were Varian, Elekta, and Bristol-Myers Squibb. Merck and Varian were the most frequent funding sources for research payments. CONCLUSIONS In this population, the majority of FCOIs were general payments, but research funding comprised the highest monetary sums. Large-volume FCOIs do not apply to the vast majority of editorial board members, implying that the maintained integrity of academic peer-review is likely not influenced to a large extent by FCOIs.
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Affiliation(s)
- Vivek Verma
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska.
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Devlin M, Maida V. The demon in deeming: Medical paternalism and linguistic issues in the palliative care setting. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:191-194. [PMID: 28292791 PMCID: PMC5349714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Melissa Devlin
- Social worker at the William Osler Health System in Toronto, Ont.
| | - Vincent Maida
- Consultant in palliative medicine at the William Osler Health System, Associate Professor in the Division of Palliative Care at the University of Toronto, and Assistant Clinical Professor in the Michael G. DeGroote School of Medicine at McMaster University in Hamilton, Ont
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Tao DL, Boothby A, McLouth J, Prasad V. Financial Conflicts of Interest Among Hematologist-Oncologists on Twitter. JAMA Intern Med 2017; 177:425-427. [PMID: 28114456 DOI: 10.1001/jamainternmed.2016.8467] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Derrick L Tao
- School of Medicine, Oregon Health & Science University, Portland
| | - Aaron Boothby
- School of Medicine, Oregon Health & Science University, Portland
| | - Joel McLouth
- School of Medicine, Oregon Health & Science University, Portland
| | - Vinay Prasad
- Division of Hematology Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland.,Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland.,Center for Health Care Ethics, Oregon Health & Science University, Portland
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Devlin M, Maida V. Le diable dans le jugement. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e150-e152. [PMID: 28292810 PMCID: PMC5349733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Melissa Devlin
- Travailleuse sociale au William Osler Health System à Toronto, en Ontario.
| | - Vincent Maida
- Consultant en médecine palliative au William Osler Health System, professeur agrégé à la Division des soins palliatifs de l'Université de Toronto et professeur clinicien adjoint à la Faculté de médecine Michael G. DeGroote de l'Université McMaster à Hamilton, en Ontario
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Linker A, Yang A, Roper N, Whitaker E, Korenstein D. Impact of industry collaboration on randomised controlled trials in oncology. Eur J Cancer 2016; 72:71-77. [PMID: 28027518 DOI: 10.1016/j.ejca.2016.11.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 11/11/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Industry funders can simply provide money or collaborate in trial design, analysis or reporting of clinical trials. Our aim was to assess the impact of industry collaboration on trial methodology and results of randomised controlled trials (RCT). METHODS We searched PubMed for oncology RCTs published May 2013 to December 2015 in peer-reviewed journals with impact factor > 5 requiring reporting of funder role. Two authors extracted methodologic (primary end-point; blinding of the patient, clinician and outcomes assessor; and analysis) and outcome data. We used descriptive statistics and two-sided Fisher exact tests to compare characteristics of trials with collaboration, with industry funding only, and without industry funding. RESULTS We included 224 trials. Compared to those without industry funding, trials with collaboration used more placebo control (RR 3·59, 95% CI [1·88-6·83], p < 0001), intention-to-treat analysis (RR 1·32, 95% CI [1·04-1·67], p = 02), and blinding of patients (RR 3·05, 95% CI [1·71-5·44], p < 0001), clinicians (RR 3·36, 95% CI [1·83-6·16], p≤·001) and outcomes assessors (RR 3·03, 95% CI [1·57-5·83], p = 0002). They did not differ in use of overall survival as a primary end-point (RR 1·27 95% CI [0·72-2·24]) and were similarly likely to report positive results (RR 1·11 95% CI [0·85-1·46], p = 0.45). Studies with funding only did not differ from those without funding. CONCLUSIONS Oncology RCTs with industry collaboration were more likely to use some high-quality methods than those without industry funding, with similar rates of positive results. Our findings suggest that collaboration is not associated with trial outcomes and that mandatory disclosure of funder roles may mitigate bias.
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Affiliation(s)
- Anne Linker
- University of California San Francisco, 631 Diamond Street, San Francisco, CA 94114, USA.
| | - Annie Yang
- Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017, USA.
| | - Nitin Roper
- National Institutes of Health/National Cancer Institute, 10 Center Drive, Bethesda, MD 20892, USA.
| | - Evans Whitaker
- Library and Center for Knowledge Management, University of California San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Deborah Korenstein
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017, USA.
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