Industry Payments Research Articles

Gender disparities in industry payments to neurosurgeons: a comprehensive analysis of Centers for Medicare & Medicaid Services Open Payments data (2016-2022).

This study aimed to investigate the extent of gender disparities in financial interactions between neurosurgeons and the medical device industry, examining the differences in the number, amount, and types of payments made to male and female neurosurgeons. Utilizing data from the Centers for Medicare & Medicaid Services Open Payments database covering 2016-2022, the authors conducted a comprehensive analysis of industry payments to neurosurgeons. This methodology included univariate and multivariate analyses to examine the disparities in payments, with a focus on identifying significant differences in compensation across genders. An analysis of 24,074 industry transactions totaling $388,916,456.88 underscored pronounced gender disparities, with female neurosurgeons involved in merely 2.47% of these transactions and receiving just 0.91% of the overall financial value. The data revealed significant discrepancies in compensation between genders across all contributing companies. Male neurosurgeons engaged in a higher average number of annual transactions compared with their female counterparts (4.60 vs 2.75, p < 0.001), across various financial interactions. This included a greater participation in royalties and licenses (1.49 vs 0.31, p < 0.001), consulting fees (2.16 vs 1.63, p = 0.024), and acquisitions (0.01 vs 0.00, p = 0.006). On average, female neurosurgeons were compensated $16,303.66, starkly lower than the $75,523.20 average received by their male counterparts (p < 0.005). This gap was especially significant in royalties and licenses, where females earned an average of $5168.57 compared with $61,898.47 for males (p = 0.004). Additionally, in acquisitions, female neurosurgeons received no payments at all, whereas males averaged $2153.43 (p = 0.042). Several of these disparities remained significant even after accounting for potential confounding factors, highlighting a systematic bias in compensation and industry engagement against female neurosurgeons. The study underscores a significant gender-based disparity in the financial interactions between neurosurgeons and the medical device industry. These disparities highlight the need for systemic changes to address the underlying factors contributing to inequity in compensation and industry collaboration opportunities. Implementing equitable compensation structures, mentorship programs, and inclusive policies is a crucial step toward achieving gender parity in neurosurgery and ensuring the field benefits from the diverse skills and perspectives of all its members.

Ten-year analysis of non-research industry payments to anesthesiologists in the United States between 2014 and 2023.

This study aimed to examine extent, fraction, and trends of general payments to anesthesiologists and non-physician anesthesia providers (NPAPs) in the United States. This is a cross-sectional analysis of general payments by pharmaceutical and medical device industry to all anesthesiologists (2014-2023) and NPAPs (2021-2023) for non-research purposes using the Open Payments Database, a federal transparency database under the Physician Payments Sunshine Act between 2014 and 2023. The United States. All active practicing anesthesiologists and NPAPs, including certified registered nurse anesthetists and anesthesiologist assistants, in the United States. Fraction of providers receiving non-research payments; total payment amounts; median payment amounts per provider; relative annual average percentage change from 2014 to 2023. A total of $297.8 million general payments were made by industry to 75.4% of all active anesthesiologists from 2014 to 2023, while $7.2 million was made to 46.8% of NPAPs from 2021 to 2023. Median annual payments ranged from $59-$120 for anesthesiologists and $37-$38 for NPAPs. The proportion of anesthesiologists receiving payments declined at a relative annual average percentage change (RAAPC) of -2.9% from 2014 to 2019, followed by a substantial decrease in 2020. Subsequently, the number of payment recipients increased at an RAAPC of 15.4% (2020-2023) for anesthesiologists and 9.0% (2021-2023) for NPAPs. Payment distribution was highly concentrated, with the top 1% of anesthesiologists and NPAPs receiving 78.2% and 52.5% of total payments in 2023, respectively. Among anesthesiology subspecialties, pain medicine physicians consistently received the highest median payments ($332-$767) throughout the study period. This study demonstrated large financial relationships between industry and anesthesia providers, with a disproportionate concentration of payments among a minority of providers.

Industry Payments to Physicians During Medical Specialty Society Conferences

Industry Payments to Physicians During Medical Specialty Society Conferences

Pharmaceutical Industry Payments to Patient Organizations in Poland: Analysis of the Patterns, Evolution, and Structure of Connections.

Drug company funding can create conflicts of interest that compromise the integrity of patient organizations, a problem studied primarily in Western Europe and North America. To address this research gap, we conducted a case study in Poland, a Central European country. Between 2012 and 2020, 33 companies reported payments worth €13 729 644 to 273 patient organizations in Poland. The funding was highly concentrated, with the top ten recipients amassing 46.2 percent of the total amount. Cancer patient organizations were the primary recipients, receiving 37.5 percent. The funding focused on patient organizations' educational activities, constituting 40.4 percent of the total. For the ten companies reporting payments consistently from 2012 to 2020, we detected an increase in both the value of individual payments and the overall value of the funding. Additionally, some patient organizations formed exclusive, or nearly exclusive, ties with single companies. Overall, our study reveals important similarities between Poland and Western countries in the reported distribution of drug company payments to patient organizations. It also highlights priority areas for further research, including the evolution and structure of the financial connections.

Does Merit-based Incentive Payment System Performance Differ Based on Orthopaedic Surgeon Gender?

Value-based care payment and delivery models such as the recently implemented Merit-based Incentive Payment System (MIPS) aim to both provide better care for patients and reduce costs of care. Gender disparities across orthopaedic surgery, encompassing reimbursement, industry payments, referrals, and patient perception, have been thoroughly studied over the years, with numerous disparities identified. However, differences in MIPS performance based on orthopaedic surgeon gender have not been comprehensively evaluated. After controlling for potentially confounding variables such as experience, geography, group size, and Medicare beneficiary characteristics, does MIPS performance differ between men and women orthopaedic surgeons? The Medicare Physician and Other Practitioners and the Physician Compare databases were queried for years 2017, the first year MIPS was incorporated, and 2021, the most recent year with MIPS data published, to identify all physicians with a self-reported specialty of orthopaedic surgery. Together, these databases include all physicians who submitted at least 11 Medicare claims each year. Physician gender, US census region, years in practice, group practice size, billing practices, and patient demographic characteristics were collected for each surgeon. The MIPS Performance database was used to extract an overall MIPS performance score for each surgeon for each year. Payment adjustments, which are determined based on overall MIPS performance score, were derived for each surgeon based on the thresholds published by the Centers for Medicare & Medicaid Services. Payment adjustments include a negative adjustment, neutral adjustment, positive adjustment, or exceptional performance bonus and are associated with different thresholds each year. Statistical differences based on surgeon gender were assessed utilizing chi-square tests for categorical data, Student t-test for parametric continuous data, and Wilcoxon signed-rank test for nonparametric continuous data. Univariable and multivariable analyses were performed to analyze the relationship between surgeon gender and MIPS performance. After controlling for other patient and surgeon variables, woman gender was associated with a slightly increased MIPS performance score in 2021 (β 1.5 [95% confidence interval (CI) 0.02 to 3.00]; p = 0.047). However, this finding was statistically fragile, with the lower bound 95% CI being very close to the line of no difference. No association between surgeon gender and MIPS performance score was found in 2017 (β 2.2 [95% CI -0.5 to 4.9]; p = 0.11). Additionally, no relationship was found between gender and receiving either an exceptional performance MIPS bonus or a MIPS penalty in either year. Women orthopaedic surgeons scored slightly higher on the MIPS in 2021, after controlling for surgeon and patient variables, despite providing care for a higher percentage of dual Medicare-Medicaid eligible patients and more medically complex patients. However, this finding was statistically fragile, with a small effect size, a 95% CI close to 0, and no consistent association in MIPS performance in 2017. Additionally, with no differences in MIPS performance bonuses or penalties, the clinical monetary impact of this difference may be minimal. The observed association between surgeon gender and MIPS performance scores in 2021, with women orthopaedic surgeons achieving slightly higher scores, raises interesting questions about potential differences in practice behaviors, communication styles, care quality, or other unmeasured variables. These findings may reflect true differences in how care is delivered or documented as scored by the MIPS. However, given the small effect size, statistical fragility, and inconsistency across years, there is a chance that this finding may be spurious. That being so, future research should aim to validate or refute these findings by examining a broader range of variables including documentation practices, practice behaviors, institutional differences, potential systemic biases in scoring methodologies, and patient outcomes. Understanding whether these differences are true is important to ensure that performance metrics like MIPS accurately and equitably reflect care quality.

A cross-sectional analysis of open payments from pharmaceutical companies to memory center physicians.

The development of anti-amyloid monoclonal antibodies has changed the landscape of care for patients with Alzheimer's disease (AD). The potential for financial conflicts of interest (COIs) for physicians related to these medications is unknown. A cross-sectional analysis of open payments from industry to physicians working in memory clinics was conducted. The US News Best Hospitals for Neurology and Neurosurgery was used to identify the top 50 ranked hospitals. For each hospital, a google search was performed to identify any affiliated memory clinic. A list of physicians practicing in the memory clinic was identified from public websites. Physician specialty (neurology, geriatrics, psychiatry, or other) was abstracted. The Center for Medicare & Medicaid Services Open Payments database was used to search for general industry payments to each physician for the years 2020-2023. Mean and median yearly payments and number of payments were calculated. Payments from all pharmaceutical companies as well as the pharmaceutical companies responsible for lecanemab (Biogen and Eisai) and donanemab (Eli Lilly and Company/Lilly USA) were abstracted. Thirty-one memory clinics with 244 total physicians were identified; 173 were neurologists, 37 psychiatrists, 30 geriatricians, and 4 other specialists. Mean one-year payment was $1562 (SD 4021) for neurologists, $974 (SD 5153) for geriatricians, and $460 (SD 1932) for psychiatrists. Forty neurologists (40/173, 23%) received mean yearly payments of ≥$1000, compared with one geriatrician (1/30, 3.3%) and two psychiatrists (2/37, 5.4%). Payments from Biogen, Eisai, and Eli Lilly and Company/Lilly USA comprised 51% of general payments. Most physicians working in a sample of memory clinics received no or low amounts of general payments. Neurologists were more likely to receive general payments from industry. Payments from Biogen, Eisai, and Eli Lilly and Company/Lilly USA were substantial. Future work should evaluate the relationship between industry payments and anti-amyloid prescribing patterns.

Effective practical strategies for statutory adjudication in construction disputes: perspectives from adjudicators

Despite the enactment of several Security of Payment Acts, disputes still on the continuous rise, and the need for a more thorough understanding of the root causes and effective strategies for statutory adjudication. Disputes and payment defaults are two critical issues faced by stakeholders in the construction industry, yet resolving them through legal means, like arbitration and litigation, is costly and time-consuming. This paper explores the practical strategies for selecting adjudication to resolve disputes, with reference to Malaysia’s Construction Industry Payment and Adjudication Act 2012 (CIPAA), via a questionnaire survey among adjudicators (N = 280). Feedback is analyzed using the Statistical Packages for Social Science and Relative Importance Index and validated by interviews with industry experts. Construction disputes identified include interim payment, payment certificates, withholding monies, final account, retention sum, variation order, certified value, professional fees, and imposition of liquidated damages that are suitable to resolve by adjudication effectively. It verified that there was no significant statistical difference in the findings among the diverse professions of the adjudicator. This study contributes to existing knowledge in disputes and statutory adjudication. It serves as a practical guide for stakeholders in selecting adjudication to resolve appropriate disputes and achieve finality while mitigating challengeable adjudication decisions.

Evaluating the Paucity of Female Surgeons in Plastic Surgery: A Review of the Systemic Barriers to Entry and Success.

The percentage of practicing female plastic surgeons in the United States is notably low. This narrative review sought to identify prominent barriers affecting women's entry and success in plastic surgery. A literature search was conducted using the National Library of Medicine from 2013 to 2023, using MeSH terms of gender disparity and plastic surgery. Included publications were peer-reviewed articles and systematic reviews evaluating gender disparity in plastic surgery, examining experiences, challenges, or opportunities for female plastic surgeons. Excluded publications did not include data gathered from the United States, included other minorities, or did not focus on plastic surgery. Overall, 191 papers were identified, with 14 papers being selected for this review. Early barriers identified before residency training include the lack of female mentors and the underrepresentation of female presenters at national plastic surgery conferences, with females comprising only 29% of presenters and 16% of abstract senior authors at national plastic surgery conferences between 2014 and 2015. During residency training, the most prominent barrier is pregnancy, with 73% of women delaying childbearing during residency and only 39% of men reporting the same. A second barrier during training includes gender disparity in the number of research publications, with females publishing 8.89 ± 0.97 publications during residency and males publishing 12.46 ± 1.08 publications (p = 0.0394). After residency training, evidence of barriers to career advancement includes poor representation of women in higher academic positions, such as program chairs and directors, with female representation of 9.2% and 13.1%, respectively, and gender disparity in industry payments. Systemic barriers before, during, and after plastic surgery residency training seem to influence the representation of women in plastic surgery at all levels. These barriers should be addressed to increase the number of practicing female plastic surgeons and diversify the field.

Industry Payments to Orthopaedic Surgeons: A Geospatial Analysis of the Open Payments Database.

There has been an increasing demand for transparency between industry and physicians. Several studies have evaluated the distribution of payment value and types to orthopaedic surgeons, but little is known about the spending patterns from an industry-centric perspective. The purpose of this study was to describe the payment patterns of top medical device companies in orthopaedics while presenting a geospatial analysis of these trends. The Open Payments database was assessed for all records of industry financial relationships with orthopaedic surgeons from 2015 to 2021. Value of financial relationships was expressed on a per orthopaedic surgeon basis, with the numerator representing total value of payments and denominator representing number of orthopaedic surgeons, and was geographically analyzed according to United States Census Divisions. Based on averages during the study period, the top 10 paying companies were (1) DePuy, (2) Zimmer Biomet, (3) Stryker Corporation, (4) Arthrex, (5) SpineFrontier, (6) Medtronic, (7) Smith and Nephew, (8) Renovis Surgical Technologies, (9) NuVasive, and (10) Paragon 28. Payments in the South Atlantic ($6,854 ± $1,265) Division were significantly greater than all other eight divisions (P < 0.001), with the next leading division being the Pacific Division ($4,114 ± $643). Five companies strongly favored one particular division, directing more than double the amount of payments to this division compared with the next leading division (SpineFrontier, 99% South Atlantic; Renovis Surgical Technologies, 81% Pacific; Paragon 28, 59% South Atlantic; NuVasive, 43% West North Central; DePuy, 35% South Atlantic). Only 3 of 10 companies were headquartered in the same division where most payments were made. From 2015 to 2021, companies preferentially supported surgeons in certain geographic regions, irrespective of where they were headquartered in. Surgeons in the South Atlantic Division received significantly more payments than any other division by a wide margin.

Trends in enforcement of National Comprehensive Cancer Network financial conflict of interest policy.

The National Comprehensive Cancer Network (NCCN) financial conflict of interest (FCOI) policy sets dollar maximums for panelists, but violations may occur. We studied NCCN Guidelines panelists for the 20 most prevalent cancers, 2013-2022. We included panelists with at least 1 full calendar year of service ("current panelists") and those who began service during the study period ("new panelists"); NCCN FCOI policy limits ($20 000 from any single company or $50 000 across all companies) apply to both groups. Industry payments were obtained from Open Payments and mapped manually via National Provider Identifier. We calculated industry payments received, excluding the same payment categories as does NCCN (research, meals, travel and lodging). We estimated whether panelists received payments exceeding NCCN limits ("violation"). As a proxy for whether panelists were subsequently disqualified as stipulated, we measured continued service for at least 1 full calendar year ("retention") subsequent to an estimated violation. We analyzed retention before and after 2016, due to increased scrutiny on NCCN FCOI in 2016. The annual proportion of current panelists with estimated violations ranged between 0.5% (2020) and 5.8% (2016). Among panelists who did vs did not have violations, retention was 83.6% vs 88.5% during 2014-2015 (odds ratio [OR] = 0.55, 95% CI = 0.26 to 1.31) and 46.6% vs 89.4% during 2017-2020 (OR = 0.10, 95% CI = 0.06 to 0.17). Among new panelists, 2.7% (5/185) had prior-year violations during 2014-2015, as did 5.5% (18/330) during 2017-2021. Each year, a small portion of panelists receive industry payments exceeding NCCN limits. Since 2016, the likelihood that such panelists will continue to serve has decreased substantially.

Robotics, money and research: is data or physician payments driving robotic bariatric surgery literature?

Physician payments from Intuitive Surgical have increased from 37 million to over 53 million per year since 2018. The study was completed to determine the accuracy of conflict of interest (COI) statements and the influence of industry payments on the valuation of the robotic platform. PubMed and Medline search for "robotic, robotic assisted" and "bariatric, Gastric Bypass, Sleeve Gastrectomy, Biliopancreatic Diversion, and Single Anastomosis Duodeno-Ileal Bypass". Manuscripts on robotic bariatric surgery with a US author with an electronic publication (EPub) date between 2018 and 2022 were included. Manuscripts were reviewed for disclosure of COI. The manuscripts were reviewed by two reviewers. The Introduction, Results, and Discussion/Conclusion were scored as Robotic Unfavorable, Neutral, or Robotic Favorable. https://OpenPaymentsData.CMS.gov was reviewed for physician payments 1year prior and 1year following the EPub date. Robotic favorable manuscripts were significantly less likely to have an adequate COI. Authors of robotic favorable manuscripts were significantly more likely to have a COI. Authors of robotic favorable manuscripts had significantly a higher Intuitive physician compensation. In addition, authors of robotic favorable manuscripts were significantly more likely to have an increase in the amount of compensation by Intuitive Surgical the following year. Our findings suggest thatIntuitive open payments have significantly influenced favorable reports inrobotic bariatricliterature. The submission of open paymentsdata, to include compensation amounts should be required for manuscript publication or acceptance to surgical conferences.

Pharmaceutical industry payments to healthcare professional organisations in the United Kingdom: a seven-year cross-sectional analysis of the Disclosure UK database from 2015 to 2021.

This study aimed to examine the size and trends in payments from the pharmaceutical industry to healthcare professional organisations (HPOs) in the United Kingdom (UK), and to characterise the conflict of interest (COI) management plans by HPOs who received large payments. Cross-sectional analysis of non-research payments disclosed in the Disclosure UK database from 2015 to 2021. United Kingdom. 148 pharmaceutical companies disclosing payment data and HPOs receiving the largest payments. Total value and median of payments per HPO; existence and content of COI policies among HPOs receiving the largest payments. A total of 898 HPOs received non-research payments worth £99.9 million (17.4% of non-research payments to all healthcare organisations). The median seven-year payment per HPO was £4509 (interquartile range: £943-£30,360). The annual payments nearly doubled from £9.3 million in 2015 to £17.6 million in 2021. Event payments constituted the largest share (£68.2 million, 68.2%). HPOs representing physicians received over 91.5% (£91.5 million) of all payments, while those related to endocrinology and diabetology - 16.3% (£16.3 million). Over 59.9% (£59.9 million) went to the 30 top-funded HPOs, of which only 17 (56.7%) had a publicly accessible COI policy. However, just 6 (35.3%) of these policies included provisions for payments from external organisations. HPOs received nearly one-fifth of pharmaceutical company payments to the UK healthcare sector. These payments were concentrated among a small number of HPOs, which often lacked effective policies for management of COI and payments from the industry.

Industry Payments to Physicians by Competing Manufacturers Within Novel Therapeutic Classes

Industry Payments to Physicians by Competing Manufacturers Within Novel Therapeutic Classes

Academic Productivity at Orthopaedic Surgery Sports Medicine Fellowship Programs in the United States Has a Weak Positive Correlation With Nonresearch Lifetime Industry Earnings

PurposeTo characterize the relationship between academic productivity, as defined by H-index, and industry payments for fellowship-trained sports medicine surgeons in faculty positions at sports medicine fellowships. MethodsThe American Orthopaedic Society for Sports Medicine (AOSSM) fellowship directory was used to create a comprehensive list of all fellowship programs nationwide. Fellowship websites were then reviewed to generate a list of the teaching faculty associated with each program. Total non-research life-time earnings was obtained from the Centers for Medicare and Medicaid Services website. Academic productivity of each fellowship faculty was assessed via H-index. Frequency counts and other descriptive statistic measures were used to describe the data for this study. Correlation was performed for continuous data using Spearman’s rho. Results90 orthopedic surgery sports medicine fellowships were identified with a combined total of 574 orthopedic surgery sports medicine fellowship faculty. There was a weak positive correlation between individual physician H-index and individual physician life-time earnings at orthopedic surgery sports medicine fellowships (p<0.001; Spearman’s rho = 0.329). There was a statistically significant difference between individual faculty H-index by quartile and individual faculty life-time earnings (test statistic: 47.3; p<0.001). There was no significant regional difference in payments but there is remarkable heterogeneity in the distribution of payments to individual physicians, with the top 10% of physicians receiving over 80% of industry dollars. ConclusionThere is a positive correlation between academic productivity and industry payments at both the individual and institutional level in orthopedic sports medicine departments, although this relationship was greater at the fellowship level. Furthermore, the majority of non-research industry funding goes to a minority of physicians. Clinical RelevanceEvaluating the impact that non-research industry payments have on a sports medicine orthopedic surgeon's research productivity can offer valuable insights into the relationship between industry compensation and scholarly output in this field.

Securing the Future: Financial Ties of Thoracic Surgery Program Directors to Industry

Thoracic surgery program directors (PDs) are key mentors for the next generation of cardiothoracic surgeons and surgeon-scientists. This study evaluates the industry payments to PDs compared to other practicing thoracic surgeons to assess potential conflicts of interest and their influence. PDs were identified using the Electronic residency application system (ERAS) and their National provider identifiers (NPIs). Industry payments from 2015 to 2021 were extracted from the OpenPayments (cms.gov) database. We analyzed the number and types of payments, including consulting fees, speaking engagements, and research-related contributions. Payments were compared by PD characteristics such as gender, specialty, and academic metrics using the Chi-square test and Kruskal-Wallis test. All 77 identified PDs (66 males and 11 females) received industry payments, totaling $14,094,422 across 8,028 transactions. The median payment was $16716, with maximum reaching $2,661,001. Male PDs and those in cardiac specialties received significantly higher payments. Research funding for PDs was predominantly awarded to males (100%). Significant disparities were observed in industry payments to PDs compared to non-PDs, especially in food and beverage, and educational activities. PDs initially received more than double the research payments compared to non-PDs in the early years. This disparity reduced significantly by 2021, reflecting a move towards more equitable research funding. The substantial payment to PDs reflects their significant role in thoracic surgery, yet raises concerns regarding potential influence on trainees. These findings underscore the need for increased transparency and measures to address disparities in industry support, particularly concerning gender and specialty.

An Overview of Open Payments: Public Reporting of Pharmaceutical and Medical Device Industry Payments to Advanced Practice Registered Nurses

In 2021, United States federal law mandated greater public transparency around the relationships between pharmaceutical and medical device companies and advanced practice registered nurses (APRNs). Pharmaceutical and device companies must report all payments, gifts, and value of meals to APRNs in a searchable database called Open Payments, which is hosted by the Centers for Medicare and Medicaid Services. In this policy feature, we introduce Open Payments, provide an overview of recent changes, and discuss implications for APRNs. We aim to familiarize APRNs with Open Payments and current publicly reported practice patterns to catalyze conversations regarding ethical interactions between industry and APRNs.

Prevalence and Extent of Industry Funding to Program Directors Across Pediatric Surgical Specialties

IntroductionIndustry funding in surgical education offers benefits but presents conflicts of interest. This study defines the prevalence and extent of industry funding to fellowship program directors (FPDs) across pediatric surgical specialties. Materials and methodsThis was a retrospective cross-sectional analysis of FPDs in pediatric surgical specialties. Data were amalgamated from the Centers for Medicare and Medicaid Services and the Accreditation Council for Graduate Medical Education. Characteristics of FPDs were obtained from academic websites and medical licensing boards. Personal industry payments from 2016 to 2022 were analyzed, and temporal trends were elucidated. Comparisons were made by year, surgical specialty, and control groups with nonparametric tests. ResultsA total of 241 FPDs were identified, with 206 (85%) receiving industry payments over the study period. The specialties with the highest prevalence of industry funding to FPDs were pediatric orthopedic surgery (100%), pediatric urology (96%), and pediatric surgery (85%). Total industry payments aggregated to $7.3 million dollars with the majority awarded to pediatric orthopedic surgery (91%). Most industry payments were for royalties or licensing (57%) and consulting fees (31%). Median total industry payments per FPD differed between subspecialties (P < 0.001) and was highest in pediatric orthopedic surgery ($7009, interquartile range [IQR], $1771-$50,239) and lowest in pediatric otolaryngology ($116, IQR, $75-$1626). Male FPDs had higher median total industry payments than female FPDs ($1643, IQR, $172-$8731 versus $193, IQR, $84-$712, P < 0.001). ConclusionsIndustry payments to FPDs in pediatric surgical specialties are highly prevalent, but the magnitude varies by specialty. Future work is needed to establish mechanisms that promote equitable partnerships between academia and industry for pediatric surgery training.

National Trends in and Concentration of Industry Payments to U.S. Psychiatrists, 2015-2021.

Industry payments to psychiatrists remain poorly characterized. Using data from the Centers for Medicare and Medicaid Services, the authors of this repeated cross-sectional study detail the extent and concentration of nonresearch industry payments to psychiatrists from 2015 to 2021. The proportion of psychiatrists receiving industry payments, payment distribution, and payment concentration among psychiatrists was assessed. Among 56,955 psychiatrists, 75.0% received any industry payments from 2015 to 2021. These payments, totaling $357,971,774, were highly concentrated: 1% of psychiatrists received 74.7% of industry payments, with notable state-level variations in concentration of top industry-paid psychiatrists. The median psychiatrist received $0 from industry each year.

"I never thought of it as payment": Qualitative evaluation of workshops with advanced practice registered nurses on pharmaceutical industry payment reporting.

With the expansion of professional autonomy and prescriptive authority of advanced practice registered nurses (APRNs), interactions with industry are under greater scrutiny. As of July 1, 2021, pharmaceutical and medical device companies must publicly report all payments to APRNs through the Centers for Medicare and Medicaid Services' Open Payments website. To gauge APRNs' familiarity with, and perceptions of the Open Payments database and discuss whether and how APRNs should respond. Virtual workshops consisting of a didactic presentation and interactive exercises with APRNs recruited through professional networks, associations, and conferences. Transcripts were analyzed using a qualitative interpretive approach, grounded in an everyday ethics theoretical framework. Thirty-six APRN clinicians, students, and faculty participated in nine workshops. Seeing sponsored meals reported in Open Payments as "payments" prompted participants to see familiar interactions in a new way. Participants valued the enhanced transparency as a way to identify risks of bias but were concerned that reporting might undermine public trust in APRNs. Emphasizing awareness as a precursor to action, participants desired greater preparation for ensuring independence in practice. The importance of tackling the ethical issues associated with industry interactions is heightened within the context of an existing climate of distrust within health care. However, many participants were concerned about the effects of transparency on public trust rather than how APRNs individually or collectively can be more trustworthy. Open Payments can serve as a useful tool to catalyze broader conversations about ethics, integrity in decision making, and health policy advocacy.

The association between gender and industry payments to minimally invasive surgeons.

It is unknown if there are differential industry payments to surgeons based on gender. This study aims to examine differences by gender for industry relations with minimally invasive surgeons, using speakers at the SAGES Annual Meeting as a proxy for key thought leaders in minimally invasive surgery. We queried the Open Payments Database for payments made to US speakers from the 2023 SAGES meeting. All payments from the prior fiscal year prior were collected. The National Provider Identity (NPI) Registry was cross-referenced to determine surgeon's self-reported gender. Industry sponsors were analyzed based on differences in payments made. A total of 305 speakers were assessed, with 175 (57.4%) males and 130 (42.6%) females. Of the 305 speakers, 246 were listed in the OPD. There were 145/175 (82.8%) males who were received general payments, compared to 101/130 (77.6%) females (p = 0.326). The total amount of industry payments was $2,894,287 for males and $1,539,481 for females. Median payments were 2.8X higher for males ($4657, IQR $422-$15,798) than females ($1651, IQR $299-$9005) (p = 0.05). Despite efforts to decrease gender bias in surgery, there remains a significant and substantial difference in payments towards male and female surgeons via industry relationships. This has potential downstream effects on career development, consulting and research opportunities, and development of new devices.