New York University School of Medicine, New York, New York.
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA Oncol. 2021 Mar 1;7(3):440-444. doi: 10.1001/jamaoncol.2020.6591.
Given the potential for undue influence of industry-physician payments on oncology care, it is important to understand how a national transparency program may be associated with financial interactions between industry and medical oncologists.
To identify trends in industry payments to medical oncologists from 2014 to 2019 and determine if the implementation of the Open Payments program is associated with changes in the frequency or value of payments or any shift in the nature of industry-oncologist financial interactions.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective, population-based, observational cohort study analyzed Open Payments reports of industry payments made in 2014 to 2019 to a cohort of licensed medical oncologists practicing in the US in 2014, using data from the National Plan and Provider Enumeration System.
Receipt of an industry payment from January 1, 2014, to December 31, 2019.
General industry payments to medical oncologists, including the proportion receiving payments, total annual value and number of payments, and average annual trends over time, by aggregate value and by nature-of-payment category. Trends over time were analyzed using linear regression and generalized estimating equations.
In 2014 to 2019, there were 15 585 medical oncologists who received a total of 2.2 million industry payments with a total value of $509 million. The absolute number of oncologists receiving payments decreased from 10 498 in 2014 to 8918 in 2019 (-15.1%). The annual per-physician payment value decreased among those receiving less than $10 000 in aggregate by -3.2% yearly (95% CI, -4.1% to -2.3%; P < .001), but increased for those receiving more than $10 000. Payments increased for consulting (13.7%; 95% CI, 12.4%-15.0%; P < .001) and for entertainment, meals, travel or lodging, and gifts (0.8%; 95% CI, 0.1%-1.5%; P = .03).
The number of medical oncologists accepting industry payments has decreased; however, high-value industry payments have been consolidated in a relatively small number of medical oncologists accepting higher payment values over time. The nature of payments has shifted toward consulting. These findings highlight the limitations of transparency without accountability.
鉴于行业与医师薪酬可能对肿瘤学护理产生不当影响，了解国家透明度计划如何与行业与肿瘤医师之间的财务互动相关联非常重要。
确定 2014 年至 2019 年期间向肿瘤医师支付的行业薪酬趋势，并确定公开支付计划的实施是否与支付频率或价值的变化相关，或与行业与肿瘤医师之间的财务互动性质的任何变化相关。
设计、环境和参与者：本回顾性、基于人群的观察队列研究分析了 2014 年至 2019 年期间向美国 2014 年执业的许可肿瘤医师群体支付的行业薪酬，使用国家计划和提供者登记系统的数据。
2014 年 1 月 1 日至 2019 年 12 月 31 日期间收到行业支付。
按总价值和支付类型，分析了肿瘤医师的一般行业支付，包括接受支付的比例、每年的总价值和支付次数以及平均年度趋势。使用线性回归和广义估计方程分析随时间的趋势。
在 2014 年至 2019 年期间，有 15585 名肿瘤医师共收到 5.09 亿美元的 220 万笔行业支付。接受支付的肿瘤医师数量从 2014 年的 10498 人减少到 2019 年的 8918 人（减少 15.1%）。每年接受不到 10000 美元总薪酬的医师的人均薪酬价值每年下降 3.2%（95%CI，-4.1%至-2.3%；P<0.001），但接受超过 10000 美元的医师薪酬有所增加。咨询（13.7%；95%CI，12.4%-15.0%；P<0.001）以及娱乐、餐饮、差旅和住宿以及礼品的支付有所增加（0.8%；95%CI，0.1%-1.5%；P=0.03）。
接受行业薪酬的肿瘤医师数量有所减少；然而，随着时间的推移，高价值的行业薪酬已经集中在接受更高支付价值的相对较少的肿瘤医师中。支付的性质已转向咨询。这些发现凸显了缺乏问责制的透明度的局限性。
