Industry payments to spine surgeons from 2014 to 2019: trends and comparison of payments to spine surgeons versus all physicians

• Published in: The spine journal 2022-06, Vol.22 (6), p.910-920
• Main Authors: Thomas, George, Bornstein, Sydney, Cho, Kevin, Rao, Raj D.
• Format: Article
• Language: English
• Subjects: Aged; Conflict of Interest; Cross-Sectional Studies; Databases, Factual; Humans; Industry; Industry payments; Medicare; Open payments database; Orthopedic Surgeons; Physician payments; Spine manufacturers; Spine surgery; Sunshine act; Surgeons; United States
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2022.01.008

•Industry payments to all physicians have increased since disclosure in the Open Payments Database.•Industry payments to spine surgeons have decreased.•Research funding of spine surgery is very low. The ethics of industry payments to physicians and the potential impact on healthcare costs and research outcomes have long been topics of debate. Industry payments to spine surgeons are frequently scrutinized. Transparency of industry relationships with physicians provides insight into their possible impact on clinical decision-making and utilization of care. : To analyze trends in medical industry payments to spine surgeons and all physicians from 2014 to 2019, and further evaluate whether specific payments to spine surgeons vary based on company size. Cross-sectional investigation of publicly reported Center for Medicare and Medicaid Services (CMS) Open Payments Database (OPD) All US providers listed as receiving industry payments with further evaluation of payments to neurosurgeons and orthopedic spine surgeons. Main measures were the magnitude and trends of industry general and research payments and subcategories of general payments, such as royalty/license and consulting fees, to spine surgeons and comparison to all physicians over the six-year period. Variations in payment patterns among spine device manufacturers with the highest reported level of spine surgeon payments in 2019. From 2014 to 2019 publicly reported general and research industry payments in the CMS OPD were analyzed. Trends in payments to all physicians were compared to trends in payments to neurosurgeons and orthopedic spine surgeons. Trends in payment patterns among spine device manufacturers with the highest payments in 2019 were determined. Linear regression analysis was completed to find statistically significant outcomes. Our investigation found an aggregate of $42,710,365,196 general and research payments reported to all physicians over the 6-year period, 2.6% ($1,112,936,203) of which went to spine surgeons. Industry general and research payments to spine surgeons decreased by 17.5% ($195,571,109, 2014; $161,283,683, 2019), while increasing by 8.7% ($6,706,208,391, 2014; $7,288,003,832, 2019) to all physicians. Industry research payments to spine surgeons were notably low each year and decreased to only 0.5% of research payments made to all physicians in 2019. Median payment received by spine surgeons as well as the overall distribution of payments to the 75th and 95th percentile s