Out of 39 specialties, radiology was in the top third when ranked by industry payments to doctors over a nine-year period, according to an article published March 28 in JAMA.
Between August 2013 and December 2022, 50% of 68,718 radiologists received industry payments totaling $392 million, lead author Ahmed Sayed, of Ain Shams University in Cairo, Egypt, and U.S. colleagues reported. The total for all U.S. physicians over the period was $12.1 billion.
“Despite evidence that financial conflicts of interest may influence physician prescribing and may damage patients’ trust in medical professionals, such relationships remain pervasive,” the group wrote.
To characterize the issue, the researchers culled payments reported in a database created in 2013 under the Physician Payments Sunshine Act, legislation designed to increase transparency in the relationship between physicians and manufacturers of drugs, devices, and biologicals.
The researchers included payments (cash and noncash equivalents) for consulting services, nonconsulting services (such as fees for serving as a speaker or faculty at a venue), food and beverages, travel and lodging, entertainment, education, gifts, grants, charitable contributions, and honoraria made to physicians. They also determined the 25 drugs and medical devices associated with the largest total payments.
Topping the list were orthopedic surgeons, who received the greatest sum of payments over the period at $1.36 billion, followed by neurologists and psychiatrists at $1.32 billion, and then cardiologists at $1.29 billion, the investigators found. Pediatric surgeons ($2.89 million) and trauma surgeons ($6.96 million) received the lowest sum of payments.
More than half of all physicians received at least one payment and payments varied widely between specialties and between physicians within the same specialty, the group added. Over the period, the mean amount paid to the top 0.1% of radiologists was $1.94 million, they reported.
Also, within each specialty, payments to the median physician ranged from $0 to $2,339; in radiology, the amount paid to the median physician ranged between $0 and $299.
“A small number of physicians received the largest amounts, often exceeding $1 million, while the median physician received much less, typically less than a hundred dollars,” the group wrote.
The three drugs associated with the most payments were Xarelto ($176.4 million), Eliquis ($102.6 million), and Humira ($100.2 million), while the three medical devices associated with the most payments were the da Vinci Surgical System ($307.5 million), Mako SmartRobotics ($50.1 million), and CoreValve Evolut ($44.8 million), according to the authors.
Sayed’s co-authors included Joseph Ross, MD, of Yale University in New Haven, CT; John Mandrola, MD, of Baptist Health in Louisville, KY; Lisa Lehmann, MD, PhD, of Harvard University in Boston; and Andrew Foy, MD, of Penn State in Hershey, PA.
The full article can be found here.
