Editors' note: Financial relationships between neurologists and industry: The 2015 Open Payments database

Abstract

In “Financial relationships between neurologists and industry: The 2015 Open Payments database,” Drs. Ahlawat and Narayanaswami analyzed payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services Open Payments database (OP). In response, Dr. Sethi argues that lack of distinction between obvious bias and potential conflicts of interest (COIs) in OP risks eroding trust in physician–patient relationships, and proposes voluntary disclosures of relevant COIs with regulatory oversight as an alternative. In contrast, Drs. Robbins and Meyer view OP as an important step towards transparency by making COIs more widely available, and towards greater divestment from financial COIs through resultant social pressure. They present data suggesting a drop in investments and financial ownership among neurologists in OP from 2013 to 2016. Responding to these comments, Drs. Ahlawat and Narayanaswami note that voluntary disclosure may be limited by failure to recognize COIs and would add to physicians' reporting burden. They acknowledge that OP is a step forward, but note that detailed clarification of the nature of payments would allow full transparency and mitigate misinterpretation. They also note that the effect of social pressure or public access to OP on divestiture would be challenging to assess. In “Financial relationships between neurologists and industry: The 2015 Open Payments database,” Drs. Ahlawat and Narayanaswami analyzed payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services Open Payments database (OP). In response, Dr. Sethi argues that lack of distinction between obvious bias and potential conflicts of interest (COIs) in OP risks eroding trust in physician–patient relationships, and proposes voluntary disclosures of relevant COIs with regulatory oversight as an alternative.