Oncologists, particularly those contributing to clinical practice guidelines, are receiving increasingly more money from pharmaceutical companies, according to research published in JNCCN.
The mean value of payments to oncologists increased from $3811 in 2014 to $5854 in 2017, and maximum payments rose from $650,100 to $923,595. The increase in payments was associated with companies marketing PD-1/PD-L1 inhibitors.
The study included US oncologists and internists with National Plan and Provider Enumeration System records and demographic data in the Centers for Medicare and Medicaid Services Physician Compare System.
Continue Reading
The researchers evaluated industry payments to the physicians using data from the Open Payments System spanning the period from 2014 to 2017. Payments considered included food and beverages, compensation, consulting fees, honoraria, and travel and lodging.
Oncologists vs Internists
The study included 13,087 medical oncologists and 85,640 internists who received payments from industry. In both cohorts, more than 60% of subjects were men.
The mean number of payments to oncologists increased from 21.4 in 2014 to 28.8 in 2017, and the mean number of payments to internists decreased from 15.3 to 14. The mean value of payments to oncologists increased from $3811 to $5854, and the mean value of payments to internists increased from $444 to $450.
In terms of maximum payment value, top oncologist payments hit $650,100 in 2014 and increased to $923,595 by 2017. Payments to internists maxed out at $264,866 in 2014 but grew to $454,109 in 2017.
The percentage of oncologists accepting payments increased over the period studied, from 65.1% to 68.7%. The percentage of oncologists who received $10,000 or more increased from 7% to 10.2%.
Panelists and PD-1/PD-L1 Inhibitors
The researchers noted that oncologists who served on NCCN guideline panels received payments of greater value and showed a greater relative increase in payments over time.
Median payments increased from $500 in 2014 to $1366 in 2017 for guideline panelists (173% increase) and from $152 to $199 for all oncologists (31% increase). Mean payments increased from $10,820 to $18,977 for panelists (75% increase) and from $3811 to $5854 for all oncologists (54% increase).
The increase in payments for oncologists was associated with companies marketing PD-1/PD-L1 inhibitors. The average per-physician payment from companies manufacturing these drugs rose from $667 in 2014 to $1767 in 2017. Per-physician payments from companies not marketing PD-1/PD-L1 inhibitors rose from $139 to $182.
“Industry influence in medical research and practice remains a concern,” the researchers wrote. “In terms of the dollar value of payments to oncologists, the basis for this concern continues to grow.”
“Ideally, medical practice and clinical practice guidelines should be based on the scientific evidence alone,” they added. “The medical community should therefore act to quickly reduce, and eventually to end entirely, the practice of accepting personal payments from industry.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Rahman MW, Trivedi NU, Bach PB, Mitchell AP. Increasing financial payments from industry to medical oncologists in the United States, 2014-2017. J Natl Compr Canc Netw. Published online December 29, 2021. doi:10.6004/jnccn.2021.7024
