Department of Orthopaedic Surgery, Stanford University, 430 Broadway Street, MC: 6342, Pavilion C, 4th Floor, Redwood City, CA 94063-6342; Department of Biomedical Data Science, Stanford University, 1265 Welch Road, Stanford, CA 94305.
Department of Orthopaedic Surgery, Stanford University, 430 Broadway Street, MC: 6342, Pavilion C, 4th Floor, Redwood City, CA 94063-6342.
Spine J. 2021 Apr;21(4):541-547. doi: 10.1016/j.spinee.2020.12.003. Epub 2020 Dec 24.
The Physician Payments Sunshine Act requires manufacturers of drugs, medical devices, medical supplies, and biologics to record all financial relationships with physicians in the Open Payments database with the goal of increasing transparency for patients and the general public. The majority of total money going to orthopedic surgeons has been found to go to a small number of surgeons in the form of royalties and licensing payments. This category of payment is intended to compensate physicians for use of their intellectual property. However, little research has been done to investigate the degree to which these physicians own intellectual property.
To the authors' knowledge, the association between patents and industry payments to orthopedic surgeons has not been explored. We quantify the association between the patents and academic productivity of orthopedic spine surgeons and the amount of royalty and licensing fees they receive. We then compared this with the associations observed for other categories of payments.
Cross-sectional study METHODS: Top royalty and licensing earners, defined as those who collectively earned 50% of all royalty and licensing payments over the period August 2013-December 2018, were identified. The h-index, publication count, and patent count of this group were compared with top earners of other payment categories using the Mann-Whitney U test. The association between (1) earnings and patent counts, (2) earnings and manuscript counts, and (3) earnings and h-index among the top royalty and licensing earners was assessed using Spearman correlation.
Top royalty and licensing earners had significantly more patents than every comparison group except the top earners of money derived from ownership in a biomedical company. For this one exception, there was a trend toward the top eight royalty and licensing earners having more patents (p=.054). The top royalty and licensing earners had significantly more manuscripts than three of the five comparison groups and significantly higher h-indices than four of the five comparison groups. Among the top royalty and licensing earners, receiving more royalty and licensing payments was associated with holding more patents, but not with publishing more papers or having higher h-indices.
There is a strong association between the number of patents authored by individual orthopedic spine surgeons and the amount of royalty and licensing fees they receive from industry. This supports the hypothesis that these payments serve as compensation to inventor-surgeons for their intellectual property.
Our findings provide new, important context for the largest category of industry payments to orthopedic spine surgeons and suggests that physicians' patents should be considered when evaluating financial transactions between industry and physicians.
《医师薪酬阳光法案》要求药品、医疗器械、医疗用品和生物制剂的制造商将所有与医生的财务关系记录在公开支付数据库中，目的是提高患者和公众的透明度。已经发现，骨科医生获得的大部分总收入以特许权使用费和许可费的形式流向少数医生。这类支付旨在补偿医生对其知识产权的使用。然而，很少有研究调查这些医生拥有知识产权的程度。
据作者所知，专利与骨科医生行业薪酬之间的关联尚未得到探讨。我们量化了专利与骨科脊柱外科医生的学术生产力以及他们获得的特许权使用费和许可费之间的关联。然后，我们将其与其他类别的支付方式的关联进行了比较。
横断面研究
确定了最高特许权使用费和许可费获得者，即 2013 年 8 月至 2018 年 12 月期间集体获得所有特许权使用费和许可费的 50%的人。使用 Mann-Whitney U 检验比较这组人与其他支付类别的顶级收入者的 h 指数、出版物数量和专利数量。使用 Spearman 相关性评估顶级特许权使用费和许可费获得者之间的（1）收入与专利数量、（2）收入与手稿数量以及（3）收入与 h 指数之间的关联。
除了从生物医学公司所有权中获得收入的最高收入者之外，顶级特许权使用费和许可费获得者的专利数量明显多于每个比较组。对于这一个例外，前 8 名特许权使用费和许可费获得者拥有更多专利的趋势（p=.054）。顶级特许权使用费和许可费获得者的手稿数量明显多于五个比较组中的三个，h 指数明显高于五个比较组中的四个。在顶级特许权使用费和许可费获得者中，获得更多的特许权使用费和许可费与拥有更多的专利有关，但与发表更多的论文或拥有更高的 h 指数无关。
个别骨科脊柱外科医生拥有的专利数量与他们从行业获得的特许权使用费和许可费金额之间存在很强的关联。这支持了这样一种假设，即这些支付是对发明外科医生知识产权的补偿。
我们的发现为骨科脊柱外科医生获得的行业薪酬中最大类别提供了新的、重要的背景，并表明在评估行业与医生之间的财务交易时，应考虑医生的专利。
