From August to December 2013, medical drug and device companies paid around $3.5 billion to physicians for speaking engagements, consultations, research and more, according to a New York Times report.
The data was released under the Sunshine Act, requiring device companies to disclose payments to physicians worth more than $10 — including dinners and other expenses. The data is made public on the Centers for Medicare and Medicaid Services' Open Payments website containing information about individual physicians.
Yesterday marked the first time this data has been made available in a large, searchable database. Many academic medical centers and hospitals post financial ties surgeons have to the device industry, and many peer-reviewed journals also have policies requiring disclosure for study authors. But the new online database gives a more global picture of how medical professionals interact with industry.
Here are 10 things to know about the $3.5 billion paid last year and expectations for the future:
1. During the five-month period examined, there were 4.4 million payments made to more than 500,000 healthcare professionals and teaching hospitals, according to the Times report.
2. Broken down by purpose, the payments went to:
• Research: $1.49 billion
• Ownership interest: $1.02 billion
• Speaking and consulting fees: $380 million
• Royalties and licenses: $302 million
• Travel, food, lodging: $167 million
• Other: $128 million
3. The biggest chunk — about $1.5 billion — of the payments were for research with an additional $302 million spent on royalties and licenses paid to physicians and teaching hospitals for product development, according to the Times report. However, around 190,000 research payments were not made public because they were for products that weren't approved or new uses for existing products.
4. There are still issues with the data — around 40 percent of the records aren't tied to a specific healthcare professional or hospital. These records account for around 64 percent of overall payments.
5. Anyone — including patients — is able to search the online database. The information is made public in an effort to promote transparency, which could eliminate unsavory behavior and inform patients about their physicians' payments. Some surgeons already disclose their industry ties to patients, and studies show in the spine field, patients don't think the financial relationship inhibits their surgeon's performance.
6. Physicians and surgeons are able to check reported data before it goes "live" to identify and correct errors. For this first disclosure period, there were only around 26,000 out of 546,000 healthcare professionals who registered to check their payments. There have already been reports of mistakes caught, some of which were not changed before the data was published.
7. Physicians and hospitals in California received around 18 percent of overall payments — or $638 million — for the five month reporting period, according to the Los Angeles Times. According to the Chicago Tribune, $75 million went to Illinois physicians and teaching hospitals, with more than 60 percent of that sum related to research. The report also noted Illinois physicians and immediate family members hold ownership stake in pharmaceutical companies and device makers worth around $29 million.
8. The report shows about $1 billion in payments were made for medical providers' ownership in companies—including grants and money physicians invested. Additional heightened scrutiny on physician-owned distributorships could make an impact on future relationships as well. Earlier this month, the United States filed two complaints under the False Claims Act related to spine-focused PODs, alleging a device company paid physicians to induce the use of their spinal implants.
9. The website does not distinguish between "beneficial" relationships and relationships that are a "conflict of interest," and several professional specialty societies — including spine societies — wrote letters to CMS asking the data not be revealed without broader context. Additionally, many complained there wasn't enough time for physicians to check the data and correct errors. Spine surgeon Eeric Truumees, MD, was cited in the LA Times article for attempting to log on to the website twice to check, but was unable to access his data.
10. The website was initially scheduled to launch earlier this year, but inaccuracies in the report forced a delay. A physician reported payments attributed to him were actually made to another physician with the same name, sparking the shut down. However, the website became functional again and CMS made the data "live" on Sept. 30.