Section of Digestive Diseases and Nutrition, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.
Section of Digestive Diseases and Nutrition, Department of Medicine, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.
JAMA Netw Open. 2018 Dec 7;1(8):e186343. doi: 10.1001/jamanetworkopen.2018.6343.
Payments from pharmaceutical and device manufacturers to physicians may influence the advice physicians give patients and peers.
To investigate the nature and amounts of monetary and other benefits that gastroenterologists received and to determine the participation of those receiving benefits in the formulation of clinical practice guidelines.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed information from the Centers for Medicare & Medicaid Services Open Payments database, including all reports about payments that pharmaceutical and device manufacturers gave to adult or pediatric gastroenterologists in 2016. PubMed was used to examine the professional affiliations and publication records of top payment recipients. Panelists of clinical guidelines who also received personal financial rewards listed in the Open Payments database were identified.
Payments made to gastroenterologists by pharmaceutical company and device manufacturers.
Of 15 497 gastroenterologists, 13 467 (86.9%) received a total of 432 463 payments accounting for a total expenditure of $67 144 862. Direct financial payments for consultations, talks, or other services were made to 2055 physicians and were responsible for 4.2% of payments (18 179 of 432 463), but for 62.7% of total expenditures ($42 086 207 of $67 144 862). Although a significant number of submissions were for food and beverages, they constituted only a small amount of total expenditure. For gastroenterologists treating adult patients, 10 products were linked to 63.8% of payments (11 221 of 17 588) related to direct financial rewards and 37.1% of the total expenditures ($24 892 643 of $67 144 862). Twenty-nine of 36 clinical practice guidelines included panelists who had received honoraria or consultation fees from industry sources, with amounts exceeding $10 000 in 8 of them (22%).
Most gastroenterologists accept meals or gifts from industry, with 2055 of 15 497 gastroenterologists receiving direct payments and 8 of 36 clinical practice guidelines panelists having received more than $10 000. Considering the known impact of such benefits on prescribing patterns and other professional behaviors, policy makers should consider revising regulations governing interactions with industry and disclosure formats alerting others to their potential biasing impact.
制药商和医疗器械制造商向医生支付的款项可能会影响医生向患者和同行提供的建议。
调查胃肠病学家获得的货币和其他福利的性质和数额，并确定获得这些福利的人参与制定临床实践指南的情况。
设计、地点和参与者：这项队列研究分析了医疗保险和医疗补助服务机构公开支付数据库中的信息，其中包括制药商和医疗器械制造商在 2016 年向成人或儿科胃肠病学家支付的所有款项报告。研究人员使用 PubMed 检查了顶级薪酬接受者的专业隶属关系和发表记录。确定了在公开支付数据库中列出的参与临床指南小组的个人财务奖励的人员。
制药商和医疗器械制造商向胃肠病学家支付的款项。
在 15497 名胃肠病学家中，有 13467 名（86.9%）共收到 432463 笔款项，支出总额为 67144862 美元。2055 名医生获得了用于咨询、演讲或其他服务的直接财务报酬，占付款的 4.2%（18179 笔交易占 432463 笔），但占总支出的 62.7%（42086207 美元占 67144862 美元）。尽管有大量的提交是关于食品和饮料的，但它们只占总支出的一小部分。对于治疗成年患者的胃肠病学家来说，有 10 种产品与 63.8%的与直接财务奖励相关的付款（11221 笔交易占 17588 笔）和 37.1%的总支出（24892643 美元占 67144862 美元）相关。36 项临床实践指南中有 29 项包含了曾从行业来源获得酬金或咨询费的小组成员，其中 8 项（22%）超过 10000 美元。
大多数胃肠病学家接受行业的膳食或礼物，在 15497 名胃肠病学家中有 2055 名接受直接付款，在 36 项临床实践指南小组中有 8 名收到超过 10000 美元。考虑到这些福利对处方模式和其他专业行为的已知影响，政策制定者应考虑修改与行业互动的监管规定，并修改披露格式，以提醒其他人注意其潜在的偏见影响。
