Analysis of Industry-Related Payments Among Physician Editors of Pathology Journals

Health Care Industry Payments to Editorial Board Members of Major Neurosurgery Journals Between 2017 and 2022

BACKGROUND AND OBJECTIVES

Financial conflicts of interest between editorial board members and industry could lead to biases and impartial editorial decisions. We aimed to evaluate the frequency, amount, and characteristics of payments to editorial board members of neurosurgery journals over a 6-year period.

METHODS

In this cross-sectional study, editorial board members were derived from the top 10 neurosurgery journals based on Google Scholar metrics. The Open Payments database by the Centers for Medicare and Medicaid Services was accessed to evaluate industry payments to editorial board members from 2017to 2022. Descriptive analyses were performed on payment data, adjusted for inflation using the consumer price indices.

RESULTS

We included 805 editorial board members. After excluding duplicate names, 342 (53.9%) of 634 had received payments between 2017 and 2022. Eight of 10 journals had more than 50% of editorial board members listed in the Open Payments database. Between 2017 and 2022, the total number of payments to editorial board members was $143 732 057, encompassing $1 323 936 in research payments, $69 122 067 in associated research funding, $5 380 926 in ownership and investment interests, and $67 905 128 in general payments. General payments decreased from $13 676 382 in 2017 to $8 528 003 in 2022. Royalties ($43 393 697) and consulting ($13 157 934) contributed the most to general payments between 2017 and 2022. Four journals had a percentage increase in total payments, whereas general payments decreased for 6 journals.

CONCLUSION

Around 54% of editorial board members of neurosurgical journals received industry payments between 2017 and 2022. We identified journal-specific trends in industry payments and highlighted the importance of transparency and disclosure of financial conflicts of interests for neurosurgery journals.

Gender Representation of Editors at Journals Affiliated with Major U.S. Medical Societies

Objectives: To assess the gender composition of upper-level specialty-specific editor positions among United States (U.S.) medical society-affiliated journals and to evaluate the equitable inclusion of women and women physicians. Materials and Methods: The gender composition of upper-level (e.g., editor-in-chief, deputy) specialty-specific editor positions among 39 U.S. medical society-affiliated journals as of January 5, 2023, was analyzed. Editor positions below the level of associate editor were excluded. Parity (50:50 representation) and equity (compared with the proportion of practicing physicians in each medical specialty) benchmarks were utilized to determine if women are underrepresented in editor positions. Results: A total of 862 editor positions among 39 journals were assessed. Women held 32.9% (284/862) of positions (95% confidence interval [CI]: 29.9%-36.2%), significantly less than expected based on the U.S. population (p < 0.001). Physicians comprised 90.8% (783/862) of positions, of whom 30.4% (238/783) were women physicians (95% CI: 27.3%-33.7%), significantly less than expected (p < 0.001). Thirty-three (84.6%, 95% CI: 70.3%-92.8%) journals were below parity for women overall, whereas 34 (87.2%, 95% CI: 73.3%-94.4%) were below parity for women physicians. Fourteen (35.9%, 95% CI: 22.7%-51.6%) journals were below equity for women physicians. Notably, 13 (33.3%, 95% CI: 20.6%-49.0%) journals were below both parity and equity for women overall and women physicians. Conclusions: This study reveals mixed results in the equitable inclusion of women in editor positions of journals affiliated with U.S. medical societies. Despite the equitable inclusion of women in editorial roles being a remediable issue, approximately one third of journals affiliated with major U.S. medical societies remain inequitable.

Open Payments Data Analysis of General and Fellowship-trained Surgeons Receiving Industry General Payments From 2016 to 2020: Payment Disparities and COVID-19 Pandemic Impact

OBJECTIVE

To characterize industry nonresearch payments made to general and fellowship-trained surgeons between 2016 and 2020.

BACKGROUND

The Centers for Medicare & Medicaid Services Open Payments Data (OPD) reports industry payments made to physicians related to drugs and medical devices. General payments are those not associated with research.

METHODS

OPD data were queried for general and fellowship-trained surgeons who received general payments from 2016 to 2020. Payments' nature, amount, company, covered product, and location were collected. Surgeons' demographics, subspecialty, and leadership roles in hospitals, societies, and editorial boards were evaluated.

RESULTS

From 2016 to 2020, 44,700 general and fellowship-trained surgeons were paid $535,425,543 in 1,440,850 general payments. The median payment was $29.18. The most frequent payments were for food and beverage (76.6%) and travel and lodging (15.6%); however, the highest dollar payments were for consulting fees ($93,128,401; 17.4%), education ($88,404,531; 16.5%), royalty or license ($87,471,238; 16.3%), and travel and lodging ($66,333,149; 12.4%). Five companies made half of all payments ($265,654,522; 49.6%): Intuitive Surgical ($128,517,411; 24%), Boston Scientific ($48,094,570; 9%), Edwards Lifesciences ($41,835,544, 7.8%), Medtronic Vascular ($33,607,136; 6.3%), and W. L. Gore & Associates ($16,626,371; 3.1%). Medical devices comprised 74.7% of payments ($399,897,217), followed by drugs and biologicals ($33,945,300; 6.3%). Texas, California, Florida, New York, and Pennsylvania received the most payments; however, the top dollar payments were in California ($65,702,579; 12.3%), Michigan ($52,990,904, 9.9%), Texas ($39,362,131; 7.4%), Maryland ($37,611,959; 7%), and Florida ($33,417,093, 6.2%). General surgery received the highest total payments ($245,031,174; 45.8%), followed by thoracic surgery ($167,806,514; 31.3%) and vascular surgery ($60,781,266; 11.4%). A total of 10,361 surgeons were paid >$5000, of which 1614 were women (15.6%); in this group, men received higher payments than women (means, $53,446 vs $22,571; P <0.001) and thoracic surgeons received highest payments (mean, $76,381; NS, P =0.14). A total of 120 surgeons were paid >$500,000 ($203,011,672; 38%)-5 non-Hispanic White (NHW) women (4.2%) and 82 NHW (68.3%), 24 Asian (20%), 7 Hispanic (5.8%), and 2 Black (1.7%) men; in this group, men received higher payments than women (means, $1,735,570 vs $684,224), and NHW men received payments double those of other men (means, $2,049,554 vs $955,368; NS, P =0.087). Among these 120 highly paid surgeons (>$500,000), 55 held hospital and departmental leadership roles, 30 were leaders in surgical societies, 27 authored clinical guidelines, and 16 served on journal editorial boards. During COVID-19, 2020 experienced half the number of payments than the preceding 3 years.

CONCLUSIONS

General and fellowship-trained surgeons received substantial industry nonresearch payments. The highest-paid recipients were men. Further work is warranted in assessing how race, gender, and leadership roles influence the nature of industry payments and surgical practice. A significant decline in payments was observed early during the COVID-19 pandemic.

Industry payments to pathologists in the USA between 2013 and 2021

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.