Financial conflicts of interest at three prominent oncology clinical pathway vendors.

Abstract

6529 Background: The American Society of Clinical Oncology (ASCO) reports that in 2015 62% of oncology practices are adhering to a clinical pathway and 31% are adhering to more than one pathway. ASCO and the American Medical Association have raised concerns about the conflicts of interest of those that design these pathways. Methods: Using the public Centers for Medicare and Medicaid Services Open Payments database, we abstracted the 2015 financial conflicts of interest for the 2016 voting members of the Value Pathways (a combined effort of US Oncology and NCCN), the medical oncology committee chairs for Via Oncology, and the medical advisory board for eviti. We focused on national pathway vendors and on non-research general payments, such as gifts, consulting, and speaker fees. Results: Nearly all involved in pathway development received non-research general payments in 2015, including 92% of US oncology, 84% of NCCN, 84% of Via Oncology, and 69% eviti. The average general payments ranged from $3.5K for US Oncology Value Pathways voting members to $15.3K for NCCN Value Pathways voting members. Eight percent of US Oncology voting members, 19% of the eviti medical advisory board, 28% of Via Oncology chairs, and 42% of NCCN voting members received $10,000 or more in general payments in 2015. Conclusions: Given the prominent role clinical pathways have on oncologists’ prescribing behavior and the often subjective nature of determining on-pathway treatment, pathway vendors should take care to make accessible their conflict of interest policies and elucidate how they manage relationships of concern.Steps would include potentially limiting the number of committee members receiving payments and limiting the amount of general payments to each physician.