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Isbester KA, Boas SR, Wee C, Summerville L, Kumar AR. A Guide to Industry Payments and an Algorithm for Their Management. Plast Reconstr Surg 2022; 149:253-261. [PMID: 34936632 DOI: 10.1097/prs.0000000000008678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The Open Payments database was created to increase transparency of industry payment relationships within medicine. The current literature often examines only 1 year of the database. In this study, the authors use 5 years of data to show trends among industry payments to plastic surgeons from 2014 to 2018. In addition, the authors lay out the basics of conflict-of-interest reporting for the new plastic surgeon. Finally, the authors suggest an algorithm for the responsible management of industry relationships. METHODS This study analyzed nonresearch payments made to plastic surgeons from January 1, 2014, to December 31, 2018. Descriptive statistics were calculated using R Statistical Software and visualized using Tableau. RESULTS A total of 304,663 payments totaling $140,889,747 were made to 8148 plastic surgeons; 41 percent ($58.28 million) was paid to 50 plastic surgeons in the form of royalty or license payments. With royalties excluded, average and median payments were $276 and $25. The average yearly total per physician was $2028. Of the 14 payment categories, 95 percent of the total amount paid was attributable payments in one of six categories. Seven hundred thirty companies reported payments to plastic surgeons from 2014 to 2018; 15 companies (2 percent) were responsible for 80 percent ($66.34 million) of the total sum paid. Allergan was responsible for $24.45 million (29.6 percent) of this amount. CONCLUSIONS Although discussions on the proper management of industry relationships continue to evolve, the data in this study illustrate the importance of managing industry relationships. The simple guidelines suggested create a basis for managing industry relationships in the career of the everyday plastic surgeon.
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Affiliation(s)
- Kelsey A Isbester
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center; and Case Western Reserve University School of Medicine
| | - Samuel R Boas
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center; and Case Western Reserve University School of Medicine
| | - Corinne Wee
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center; and Case Western Reserve University School of Medicine
| | - Lesley Summerville
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center; and Case Western Reserve University School of Medicine
| | - Anand R Kumar
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center; and Case Western Reserve University School of Medicine
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Singerman KW, Moore MG, Kortlever JTP, Gobble RM. Industry Payments to Plastic Surgeons, 2013 to 2018: Who's Getting Paid? Plast Reconstr Surg 2022; 149:264-274. [PMID: 34936634 DOI: 10.1097/prs.0000000000008683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Physician Payments Sunshine Act of 2010 mandated that all industry payments to physicians be publicly disclosed. To date, industry support of plastic surgeons has not been longitudinally characterized. The authors seek to evaluate payment trends from 2013 to 2018 and characteristics across plastic surgeon recipients of industry payments. METHODS The authors cross-referenced those in the 2019 American Society of Plastic Surgeons member database with Centers for Medicare & Medicaid Services Open Payments database physician profile identification number indicating industry funds received within the study period. We categorized surgeons by years since American Board of Plastic Surgery certification, practice region, and academic affiliation. RESULTS A sum of $89,436,100 (247,614 payments) was received by 3855 plastic surgeons. The top 1 percent of earners (n = 39) by dollar amount received 52 percent of industry dollars to plastic surgeons; of these, nine (23 percent) were academic. Overall, 428 surgeons (11 percent) were academic and received comparable dollar amounts from industry as their nonacademic counterparts. Neither geographic location nor years of experience were independent predictors of payments received. The majority of individual transactions were for food and beverage, whereas the majority of industry dollars were typically for royalties or license. CONCLUSIONS Over half of all industry dollars transferred went to just 1 percent of American Society of Plastic Surgeons members receiving payments between 2013 and 2018. Considerable heterogeneity exists when accounting for payment subcategories.
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Affiliation(s)
- Kyle W Singerman
- From the University of Cincinnati College of Medicine; and Dell Medical School, University of Texas at Austin
| | - Meredith G Moore
- From the University of Cincinnati College of Medicine; and Dell Medical School, University of Texas at Austin
| | - Joost T P Kortlever
- From the University of Cincinnati College of Medicine; and Dell Medical School, University of Texas at Austin
| | - Ryan M Gobble
- From the University of Cincinnati College of Medicine; and Dell Medical School, University of Texas at Austin
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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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Derakhshan A, Reny DC, Rathi VK, McCarty JC, Lindsay RW, Lee LN, Gadkaree SK. Otolaryngologists Trail Other Specialties in Industry Payments From Dermal Filler Companies. Laryngoscope 2021; 132:301-306. [PMID: 34236083 DOI: 10.1002/lary.29746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/13/2021] [Accepted: 06/29/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS Dermal filler (DF) is a widely used nonsurgical option for facial rejuvenation with a rapidly expanding market. Physician payments by DF industry leaders have yet to be characterized. We sought to investigate trends in physician-industry payments by DF companies over 6 years. Differences in payments based on physician specialty and time were characterized. STUDY DESIGN Database review. METHODS The Open Payments Database was queried from 2013 to 2018. Payments made by the three largest DF companies by market share to otolaryngologists, plastic surgeons, and dermatologists were analyzed. Total dollars paid, number of payments made, type of payments made, and total number of specialists paid were recorded. One-way ANOVA was used for statistical analysis. RESULTS Otolaryngologists, plastic surgeons, and dermatologists received average annual payments of $0.36 million, $6.3 million, and $6.6 million respectively (P < .001). An average of 330 otolaryngologists, 2,128 plastic surgeons, and 5,980 dermatologists were paid annually (P < .001). Accredited speaking arrangements, consulting fees, and royalty/licensing fees comprised the majority of dollars paid to physicians. CONCLUSIONS Average physician payment by DF companies exceeds $12 million annually, with otolaryngologists receiving significantly less compared to plastic surgeons and dermatologists. LEVEL OF EVIDENCE Not applicable Laryngoscope, 2021.
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Affiliation(s)
- Adeeb Derakhshan
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Danielle C Reny
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Vinay K Rathi
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Justin C McCarty
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.,Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Robin W Lindsay
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Linda N Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Shekhar K Gadkaree
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
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Goel V, Patwardhan AM, Ibrahim M, Yang Y, Sivanesan E, Banik RK, Shannon C, Shankar H. Industry Payments to Pain Medicine Physicians: An Analysis of the Centers for Medicare and Medicaid Services Open Payments Program. PAIN MEDICINE 2021; 22:1376-1386. [PMID: 33765136 DOI: 10.1093/pm/pnaa450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To analyze industry payments to pain medicine physicians in the United States. DESIGN Retrospective cohort study using publicly available databases. SUBJECTS The study includes U.S. pain medicine physicians (PMPs) with reports in the Open Payments program from 2013 to 2018. METHODS The Centers for Medicare and Medicaid Services Open Payments program was analyzed for general, investment, and ownership payments to PMPs reported from 2013 to 2018. The nature, type, and geographic variation of payments were analyzed. RESULTS The main findings of the study are as follows: 1) Payments made to PMPs constituted a small proportion of the payments made to all physicians in the United States, and the number of transactions and the total dollar amount seem to have decreased from 2016 to 2018. 2) The median number of payments among physicians with reported payments was around 4 (interquartile range: 18), and the majority of them were under $20. 3) The majority of payments were for in-kind items and services (85%) and were made for food and beverages (91%), travel and lodging (5.5%). 4) Some of the ownership and investment interest payments exceeded $500,000. 5) The top five drugs associated with physician payments included medications with opioids. 6) A very small minority of payments were made for entertainment or gifts. 7) A third of PMPs with reports had payments reported under more than one taxonomy. CONCLUSIONS Overall payments made to PMPs seem to be decreasing since 2016. The majority of the payments are made for the food, beverage, and travel categories. Public and physician awareness of the Open Payments system reports is essential to promote transparency and to minimize adverse effects of financial relationships on patient care.
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Affiliation(s)
- Vasudha Goel
- Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amol M Patwardhan
- Department of Anesthesiology, University of Arizona, Tucson, Arizona, USA
| | - Mohab Ibrahim
- Department of Anesthesiology, University of Arizona, Tucson, Arizona, USA
| | - Yan Yang
- Department of Pain Management, Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Eellan Sivanesan
- Department of Anesthesiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ratan K Banik
- Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Clarence Shannon
- Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Hariharan Shankar
- Department of Anesthesiology, Clement Zablocki VA Medical Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Sun F, Yang F, Zheng S. Evaluation of the Liver Disease Information in Baidu Encyclopedia and Wikipedia: Longitudinal Study. J Med Internet Res 2021; 23:e17680. [PMID: 33459597 PMCID: PMC7850904 DOI: 10.2196/17680] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/15/2020] [Accepted: 12/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background The internet has changed the way of people acquiring health information. Previous studies have shown that Wikipedia is a reasonably reliable medical resource, and it has been ranked higher than other general websites in various search engines. Baidu Encyclopedia is one of the most popular encyclopedia websites in China. However, no studies have shown the quality of the content provided in the Baidu Encyclopedia. Objective This study aimed to evaluate the quality of liver disease information provided by Wikipedia (in English) and Baidu Encyclopedia (in Chinese) and to perform a comparison of the quality and timeliness of the articles published in these two encyclopedias. Moreover, a 3-year follow-up study was conducted to compare if the information in both these websites was updated regularly over this period. Methods We searched for information on liver diseases by using the International Statistical Classification of Diseases and Related Health Problems 10th Revision Version 2016 codes on Wikipedia (in English) and Baidu Encyclopedia (in Chinese). The quality of the articles was assessed using the DISCERN instrument, which consists of 3 sections. We recorded the latest editing date of the webpages and calculated the date interval to evaluate the update timeliness of these websites. Results We found 22 entries on liver diseases in Baidu Encyclopedia and 15 articles in Wikipedia between September 15, 2016, and September 30, 2016, and we found 25 entries in Baidu Encyclopedia and 16 articles in Wikipedia between September 15, 2019, and September 30, 2019. In section 1 of the DISCERN instrument, the mean (SE) scores of Baidu Encyclopedia entries were significantly lower than those of Wikipedia articles. In section 2 and section 3 of the DISCERN instrument, the DISCERN scores of Baidu Encyclopedia entries were lower than those of Wikipedia articles, but the differences were not statistically significant. The total DISCERN scores of Baidu Encyclopedia entries were significantly lower than those of Wikipedia articles. The update interval of the entries in Baidu Encyclopedia was found to be significantly longer than that of the articles in Wikipedia. Conclusions This study shows that the quality of articles and the reliability of the research content on liver diseases in Wikipedia are better than those of the entries in Baidu Encyclopedia. However, the quality of the treatment choices provided in both Wikipedia and Baidu Encyclopedia is not satisfactory. Wikipedia is updated more frequently than Baidu Encyclopedia, thereby ensuring that the information presented has the most recent research findings. The findings of our study suggest that in order to find accurate health information, it is important to seek the help of medical professionals instead of looking for a prescription amid the confusing information provided on the internet.
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Affiliation(s)
- Fei Sun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fuchun Yang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shusen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Cheng T, Boelitz K, Rybin D, Menard MT, Kalish J, Siracuse JJ, Farber A, Jones DW. Nationwide patterns in industry payments to academic vascular surgeons. J Vasc Surg 2020; 73:675-681. [PMID: 32535153 DOI: 10.1016/j.jvs.2020.04.527] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Financial relationships between vascular surgeons and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly available financial transactions between industry and academic vascular surgeons. METHODS Academic vascular surgeons were identified and characterized on the basis of publicly available data correlated with Accreditation Council for Graduate Medical Education and Association of American Medical Colleges data to identify academic practice settings. Vascular surgeons were linked to Open Payments data for 2017 as reported by the Centers for Medicare & Medicaid Services. Univariate and nonparametric tests were used for analysis. RESULTS Of 1158 academic vascular surgeons identified, 997 (86%) received industry payments totaling $8,548,034. Overall, the median of total payments received was $814 (interquartile range [IQR], $124-$2863). The top paid decile of vascular surgeons received $29,645 (IQR, $16,128-$61,701). Payments to the top decile accounted for 81% of all payments. Payments did not vary by academic rank but did vary by sex, with male vascular surgeons (n = 954) receiving $889 (IQR, $146-$3217) vs female vascular surgeons (n = 204) receiving $467 (IQR, $87-$1533; P = .002). By leadership role, division chiefs received the highest median payment amount ($1571; IQR, $368-$11,281) compared with department chairs ($424; IQR, $56-$2698) and vascular surgeons without leadership role ($769; IQR, $117-$2592; P = .002). Differences in payments were also seen on the basis of U.S. census region: Northeast, $571 (IQR, $90-2462); Midwest, $590 (IQR, $75-$2364); South, $1085 (IQR, $241-$3405); and West, $1044 (IQR, $161-$4887; P = .001). The most common categories of payments were food and beverage (paid to 85% of all vascular surgeons), travel and lodging (35%), and consulting fees (13%). Among the top decile of vascular surgeons, median payments exceeded $10,000 for three categories: consulting fees, compensation, and honoraria. Payments were made by 178 distinct entities with median total payments of $286 (IQR, $70-$6285). The three top entities paid a total of $5,004,061, which accounted for 59% of all payments. Payments from at least one of the top three entities reached 76% of vascular surgeons. CONCLUSIONS Most academic vascular surgeons receive publicly reported industry payments that are paid by a limited number of entities, typically for food and beverage or travel and lodging. The top 10% of vascular surgeons received higher median payment amounts, totaling 81% of all industry payments. Vascular surgeons should be aware of publicly reported payment information and the potential for conflicts of interest.
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Affiliation(s)
- Thomas Cheng
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Kris Boelitz
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Denis Rybin
- Department of Biostatistics, Boston University School of Public Health, Boston, Mass
| | - Matthew T Menard
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, Mass
| | - Jeffrey Kalish
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Jeffrey J Siracuse
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Alik Farber
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Douglas W Jones
- Division of Vascular and Endovascular Surgery, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Mass.
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