Abstract

Background: The Sunshine Act mandates that medical product manufacturers disclose payments and other transfers of value made to physicians or teaching hospitals. There is a lack of data characterizing payments received by cardiologists by sub-specialty. Methods: Using data from Open Payments Program for the year 2016 we aggregated payments made to individual cardiologists and analyzed the characteristics and distribution of payments by specialty - general cardiologists (GC), electrophysiologists (EP) and interventional cardiologists (IC). We calculated the Gini index, a measure of income dispersion in a group (index ‘0’ means payments are equally distributed; ‘1’ means one person received all payments). Results: A total of $1,598,677,844 was paid to 25,310 cardiologists in 2016, representing 84% of practicing cardiologists. The median annual aggregate value of payment was $2,245 for EP, $357 for GC and $1,143 for IC (p<0.05); the median number of payments was 35 for EP, 11 for GC and 35 for IC (p<0.05). The Gini index was 0.92 for GC, 0.80 for EP and 0.84 for IC. The products associated with the highest payment amounts were Xarelto (10%), Eliquis (7%) and Entresto (7%). The food and beverage category represented 88% of the total number of payments, but it constituted only 14% of the total amount. Conclusion: There is variation in payments among the three cardiology specialties, with EP receiving the highest median number and value of payments. Future analyses are needed to determine if payments are associated with changes in practice patterns.

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