A recent study published in the Journal of Clinical Oncology researched the impact of the Open Payments program on how oncologists engage with the pharmaceutical industry. According to the study, industry-physician financial relationships in the field of oncology are common and can lead to conflicts of interest. The authors attempted to evaluate trends in physician-level payments to see whether the implementation of Open Payments has resulted in fewer physicians interacting with industry and whether it shifted the nature of interactions at all.
Study Method
To that end, authors of the study performed a retrospective cohort study of medical oncologists in the United States in 2014 from the National Plan and Provider Enumeration System. They then matched Open Payments data for general (non-research) payments between 2014 and 2017 to individual physicians to evaluate the receipt of payments over the course of time. The authors then calculated the percentage of physicians who received payments, the annual value and number of payments, and average annual trends over time (including nature of payment).
Findings
The researchers found that from 2014 to 2017, medical oncologists received 1.4 million industry payments totaling $330.6 million. Over the course of time, the absolute number of medical oncologists who received payments decreased an average of 4% annually, resulting in an overall decline from 67.2% to 59.6%.
Interestingly, the value and number of payments did not significantly change over that time period. The value and number of food/beverage payments remained the same over time while the value and number of royalty/licensing payments increased.
The study also found that the value and number of payments increased for accredited/certified CME (up 821% and up 209% annually, respectively) while the value and number of payments decreased for non-accredited/certified CME (down 18% and down 25%, respectively).
Conclusion
According to this study, it seems as though while fewer oncologists overall are receiving payments, spending has not decreased. It may be reasonable to assume, therefore, that physicians are less likely to engage with manufacturers and industry is more selective. However, the authors of the study believed that since food and beverage payments are not decreasing, it is possible that those types of interactions are not heralded as problematic.
The authors also concluded that the increasing royalty/licensing payments requires ongoing scrutiny and that the changes in physician payments and behavior since the implementation of Open Payments shows the importance of transparency in policymaking.