Industry payments to physicians reach $12B over 10-year period

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Physicians pocketed more than $12.13 billion in industry payments from drug and equipment makers in the decade 2013 to 2022, according to a new study.

In August 2013, doctors began logging their industry payments in the Open Payments database created by the Physician Payments Sunshine Act. They found more than 85.08 million cash and noncash equivalent payments to 826,313, or 57.1%, of more than 1.44 million eligible physicians, according to the research letter, “Industry Payments to U.S. Physicians by Specialty and Product Type,” published online March 28 and online April 16 by JAMA.

“Despite evidence that financial conflicts of interest may influence physician prescribing and may damage patients’ trust in medical professionals, such relationships remain pervasive,” the study said.

The researchers noted payments were skewed within each medical specialty, with the largest amounts going to a small number of physicians. The median payment was $48 per doctor, and family physicians took home a median payment of $23.

But there were substantially greater mean amounts for the top 0.1% of physicians. At the top were 48,665 orthopedist doctors; 31,620 of them, or 65%, received more than $1.36 billion in payments. The amount paid to the median physician was $1,187, while the mean amount was $4.82 million for the top 0.1%.

Neurology and psychiatry were second for the total amount paid at more than $1.32 billion, with 58,688 of 107,684 doctors, or 54.5%, collecting payments. The median amount was $32, but the mean amount for the top 0.1% was $2.58 million.

General internal medicine ranked fifth overall for total amount paid, more than $588.24 million overall. There were 176,079 physicians and 97,542, or 55.4%, received payments. The median amount was $30, but the mean amount for the top 0.1% was more than $1.04 million.

At the bottom were 1,577 pediatric surgeons; 966, or 62.8%, collected a total of more than $2.89 million. The median amount was $74, with the mean amount for the top 0.1% at $338,183.

The data were not complete for 2013. From 2014 to 2022, the total value of payments peaked at $1.6 billion in 2019, and dipped to the low of $863.93 million in 2020. In 2015, payments went to the greatest number of doctors – 468,164 – and declined to the low of 359,509 in 2020. Total payments changed from $1.34 billion to 443,367 physicians in 2014, to $1.28 billion to 424,417 doctors in 2022.

The researchers also studied drug and device makers offering compensation to doctors.

The top three drugs were the blood thinner Xarelto at $176.34 million to physicians; the blood thinner Eliquis at $102.62 million; and Humira, used to treat arthritis and other conditions, at $100.17 million.

For medical devices, the da Vinci Surgical System paid $307.52 million to physicians. Mako SmartRobotics was second at $50.13 million, and CoreValue Evolut was third at $44.79 million.

The researchers noted limitations including lack of recording payments to other health care professionals; logging payments to nurses, nurse practitioners and physician assistants began in 2021. The disclosures rely on industry reporting and did not include data on some payments, such as free drug samples, which may underestimate financial transactions.