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Gender inequities in editorial board representation and physician compensation are well documented, but few studies have focused on how editors of journals are compensated. In this cross-sectional study, we examined industry-related compensation (from 2014 to 2020) among physician editors of 35 pathology journals using publicly available data from the Centers for Medicare & Medicaid Services Open Payments Database. Of the physician editors included, 135 (69.9%) were men and 58 (30.1%) were women. Similar percentages of men and women physicians who were eligible received payments (112/135 [83.0%] men and 51/58 [87.9%] women; P = .38, χ2 test). Of the total transfer of value ($211,192,532), 112 men received $192,727,555 (91.3%), and 51 women received $18,464,978 (8.7%). Mean total payment per person was $1,720,782 for men and $362,058 for women (P = .05). The payment range for men was $18-$47,568,400 and the range of payments for women was $31-$2,375,637. The findings highlight significant gender inequities in industry-related payments to physician editors of pathology journals. The financial relationships of journal editors and industry deserve further study, particularly as they relate to advancing science and closing both workforce and patient care inequities.

Physician-industry relationships have been complex in modern medicine. Since large proportions of research, education and consulting are industry-backed, this is an important area to consider when examining gender inequality in medicine. The Open Payments Program (OPP) database from August 2013 to December 2016 was analyzed. In order to identify physicians' genders, the OPP was matched with the National Provider Index dataset. Descriptive statistics of payments to female compared to male surgeons were obtained and stratified by payment type, subspecialty, geographic location and year. 3,925,707 transactions to 136,845 physicians were analyzed. Of them, 31,297 physicians were surgeons with an average payment per provider of $131,252 to male surgeons compared to $62,101 to female surgeons. Significantly fewer women received consultant, royalty/licensure, ownership and speaker payments. However, women received a higher average amount per surgeon compared to their male counterparts within research payments. Overall payments to women trended upwards over time. Gender inequality still exists in medicine, and in industry-physician payments. Industry should increasingly consider engaging women in consultancies, speaking engagements, and research. •The average payment per surgeon was $121,285- $62,101 to females and $131,252 to males.•Women in colorectal surgery, surgical oncology, general surgery and pediatric surgery, received higher payments.•Percent of payments to female surgeons had large variation-between 0.01% and 45.9%.

BackgroundThe Physician Payments Sunshine Act, part of the Affordable Care Act, requires pharmaceutical and medical device firms to report payments they make to physicians and, through its Open Payments program, makes this information publicly available.ObjectiveTo establish estimates of the exposure of the American patient population to physicians who accept industry payments, to compare these population-based estimates to physician-based estimates of industry contact, and to investigate Americans’ awareness of industry payments.DesignCross-sectional survey conducted in late September and early October 2014, with data linkage of respondents’ physicians to Open Payments data.ParticipantsA total of 3542 adults drawn from a large, nationally representative household panel.Main MeasuresRespondents’ contact with physicians reported in Open Payments to have received industry payments; respondents’ awareness that physicians receive payments from industry and that payment information is publicly available; respondents’ knowledge of whether their own physician received industry payments.Key ResultsAmong the 1987 respondents who could be matched to a specific physician, 65% saw a physician who had received an industry payment during the previous 12 months. This population-based estimate of exposure to industry contact is much higher than physician-based estimates from the same period, which indicate that 41% of physicians received an industry payment. Across the six most frequently visited specialties, patient contact with physicians who had received an industry payment ranged from 60 to 85%; the percentage of physicians with industry contact in these specialties was much lower (35–56%). Only 12% of survey respondents knew that payment information was publicly available, and only 5% knew whether their own doctor had received payments.ConclusionsPatients’ contact with physicians who receive industry payments is more prevalent than physician-based measures of industry contact would suggest. Very few Americans know whether their own doctor has received industry payments or are aware that payment information is publicly available.

BackgroundThe impact of the COVID-19 pandemic on physician relationships with industry and subsequent financial implications has not been previously assessed. The aim of this study is to compare pre- and post-COVID-19 payments between industry and medical providers for all plastic surgeons.MethodsPayment information was collected for the 2019 and 2020 reporting periods from the Open Payments Program (OPP) database for plastic surgeons and plastic surgeon subspecialists. An analysis was performed of trends and comparison of payments for each year for all plastic surgeons and each subspecialty cohort.ResultsFor all plastic surgeons, there was a decrease in industry payments between 2019 and 2020 (− 30.5%). All plastic surgery subspecialties had a decrease in payments with general plastic and reconstructive surgery affected the most (− 56%) and craniofacial surgery affected the least (− 9%). Payments for almost all categories for plastic surgeons decreased along with compensation as faculty or as speakers. Total charitable contributions and grant payments increased by 61 and 273%, respectively.ConclusionAnalysis of industry–physician payments available through the Sunshine Act shows that the COVID-19 pandemic has significantly impacted industry payments to plastic surgery and its subspecialties. While this study demonstrates the economic impact of the current pandemic, only time will tell whether these trends will persist in the coming years.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background While many new medications may offer advantages over existing drugs, some newer drugs are reformulations of existing products that provide little innovation or incremental benefit while driving up drug costs. Despite the lack of benefit of these medications, prescribers may be motivated by payments made by the pharmaceutical industry. The objective of the study was to determine the association between payments made to physicians by the pharmaceutical industry and prescriptions for certain selected costly brand name drugs. Methods This was a cross-sectional, retrospective study linking the Open Payments Database and Medicare Part D Prescriber Public Use File for 2014, including 667,278 physicians who prescribed one of 6 brand-name drugs with less costly but similarly effective alternatives: lovastatin ER, almotriptan, amlodipine+olmesartan, ibuprofen+famotidine, saxagliptin+metformin and naproxen+esomeprazole. The primary outcome was the odds of a physician prescribing one of the selected drugs, and the primary predictor was the receipt of any payment from the pharmaceutical industry. Results The odds of prescribing 3 of the 6 drugs were increased among physicians who received industry payment, compared to those without payment: amlodipine+olmesartan, aOR 1.42, (95% CI 1.36–1.49); saxagliptin+metformin, aOR 1.50, (95% CI 1.42–1.59); and naproxen+esomeprazole, aOR 1.45, (95% CI 1.25–1.68). Payment from the manufacturer of the specific drug, compared to not receiving payment from the drug’s manufacturer, was associated with increased odds of prescribing 4 of the 6 drugs: amlodipine+olmesartan, aOR 2.40, (95% CI 2.29–2.52), ibuprofen+famotidine, aOR 8.06, (95% CI 5.42–12.00), saxagliptin+metformin, aOR 2.21, (95% CI 2.10–2.34) and naproxen+esomeprazole, aOR 5.96, (95% CI 5.08–7.00). Conclusions A physician-industry financial relationship was associated with increased odds of prescribing costly brand-name drugs of uncertain medical benefit. Patients, as healthcare consumers, should demand transparency from their physicians about payment from the pharmaceutical industry to increase shared decision-making. Physician and policy makers need increased awareness and reflection on how industry payment influences their prescribing practices.

The integration of pharmaceutical and medical device companies with clinical practice is under scrutiny due to financial incentives that may influence oncology care. The Physician Payments Sunshine Act mandates transparency in these financial relationships. This study examines the trends in non-research payments to oncology specialists between 2017 and 2023, analyzing amounts, reasons, and variations by subspecialty and region. We conducted a retrospective analysis of the Centers for Medicare and Medicaid Services Open Payments database, focusing on U.S.-based hematology, medical oncology, and hematology-oncology specialists. Payments were categorized by amount, purpose, and payment type, with temporal and geographic comparisons. Data analysis was conducted in Rstudio (version 2022.07.0) with Kruskal-Wallis, Mann-Whitney U, and Chi-square tests to assess statistical significance across specialties, regions, and payment periods. Between 2017 and 2023, 2,158,140 payments totaling $601,567,196.10 were made to 19,585 U.S.-based hematology, medical oncology, and hematology-oncology specialists. Hematology-oncology received the highest total payment amount ($393,169,915.10) and transaction count (1,700,202), while hematology had the highest median payment ($23.05) compared to hematology-oncology ($18.12) and medical oncology ($19.5). Payment patterns demonstrated seasonal peaks, particularly in Q1 and Q4, and increased markedly during major oncology conferences (ASCO, ASH). Analysis by geographic region revealed that the South consistently received the highest total payments, peaking at $36.8 million in 2023, while the Northeast had the highest median payment values, reaching $22.87 in 2023. The COVID-19 pandemic corresponded with lasting shifts in payment patterns, with median payment values rising significantly during the pandemic period and remaining elevated post-COVID across all specialties. Additionally, the distribution of payments by type revealed that direct cash payments and consulting fees were the most prominent, with hematology-oncology showing the greatest reliance on high-value cash transactions, while stock payments featured prominently in hematology. Sensitivity analyses confirmed these patterns as robust, with minimal variance observed when excluding extreme values, further validating consistent trends across specialties, regions, and periods. This study reveals specialty- and region-specific variations in oncology-related payments, with significant increases during key conferences and the COVID-19 pandemic. These findings underscore the importance of continued transparency and scrutiny in industry-oncology financial interactions to mitigate potential conflicts of interest in oncology care.

Abstract BACKGROUND The Open Payments Database (OPD) started in 2013 to combat financial conflicts of interest between physicians and medical industry. OBJECTIVE To evaluate the first 5 yr of the OPD regarding industry-sponsored research funding (ISRF) in neurosurgery. METHODS The Open Payments Research Payments dataset was examined from 2014 to 2018 for payments where the clinical primary investigator identified their specialty as neurosurgery. RESULTS Between 2014 and 2018, a $106.77 million in ISRF was made to 731 neurosurgeons. Fewer than 11% of neurosurgeons received ISRF yearly. The average received $140 000 in total but the median received $30,000. This was because the highest paid neurosurgeon received $3.56 million. A greater proportion ISRF was made to neurosurgeons affiliated with teaching institutions when compared to other specialties (26.74% vs 20.89%, P = .0021). The proportion of the total value of ISRF distributed to neurosurgery declined from 0.43% of payments to all specialties in 2014 to 0.37% in 2018 (P < .001), but no steady decline was observed from year to year. CONCLUSION ISRF to neurosurgeons comprises a small percentage of research payments made to medical research by industry sponsors. Although a greater percentage of payments are made to neurosurgeons in teaching institutions compared to other specialties, the majority is given to neurosurgeons not affiliated with a teaching institution. A significant percentage of ISRF is given to a small percentage of neurosurgeons. There may be opportunities for more neurosurgeons to engage in industry-sponsored research to advance our field as long as full and complete disclosures can always be made.

This study aimed to examine extent, fraction, and trends of general payments to anesthesiologists and non-physician anesthesia providers (NPAPs) in the United States. This is a cross-sectional analysis of general payments by pharmaceutical and medical device industry to all anesthesiologists (2014–2023) and NPAPs (2021−2023) for non-research purposes using the Open Payments Database, a federal transparency database under the Physician Payments Sunshine Act between 2014 and 2023. The United States. All active practicing anesthesiologists and NPAPs, including certified registered nurse anesthetists and anesthesiologist assistants, in the United States. Fraction of providers receiving non-research payments; total payment amounts; median payment amounts per provider; relative annual average percentage change from 2014 to 2023. A total of $297.8 million general payments were made by industry to 75.4 % of all active anesthesiologists from 2014 to 2023, while $7.2 million was made to 46.8 % of NPAPs from 2021 to 2023. Median annual payments ranged from $59–$120 for anesthesiologists and $37–$38 for NPAPs. The proportion of anesthesiologists receiving payments declined at a relative annual average percentage change (RAAPC) of −2.9 % from 2014 to 2019, followed by a substantial decrease in 2020. Subsequently, the number of payment recipients increased at an RAAPC of 15.4 % (2020−2023) for anesthesiologists and 9.0 % (2021–2023) for NPAPs. Payment distribution was highly concentrated, with the top 1 % of anesthesiologists and NPAPs receiving 78.2 % and 52.5 % of total payments in 2023, respectively. Among anesthesiology subspecialties, pain medicine physicians consistently received the highest median payments ($332–$767) throughout the study period. This study demonstrated large financial relationships between industry and anesthesia providers, with a disproportionate concentration of payments among a minority of providers. •Financial relationships with healthcare industry can be conflicts of interest.•Three-quarters (75.4 %) of all anesthesiologists received non-research payments totaling $297.8 million from 2014 to 2023.•46.8 % of non-physician anesthesia providers received $7.2 million from 2021 to 2023.•Payments were highly concentrated, with the top 1 % of anesthesiologists receiving 78.2 % of total payments.

Background: Since the Physician Payments Sunshine Act in 2010, a substantial body of work has explored the supplemental income received by physicians to understand trends in industry payments and investigate sources of bias. To date, no study has examined how various fellowship characteristics impact industry earning levels at foot and ankle orthopaedic surgery fellowships. The purpose of this study is to examine the various fellowship and faculty-specific variables in correlation with industry earnings in foot and ankle orthopaedic surgery fellowships. Methods: This study is a retrospective analysis of foot and ankle orthopaedic surgery fellowships and respective faculty along with various fellowship characteristics in correlation to industry lifetime earning levels as of March 2023. Industry total lifetime earnings represent income directly paid to physicians, is not part of the physician's salary, and does not include any research grants or funding. Lifetime earnings represent all years recorded on the Open Payments Database website (2015-2021). Results: There are 165 faculty physicians and 48 programs with complete data out of all foot and ankle orthopaedic surgery fellowship programs in the United States. The mean fellowship H-Index per fellowship was 48.94 ± 38.92, and the mean fellowship lifetime earning was $1 551 791.66 ± $4 136 091.64. There was no significant association between fellowship lifetime earnings and Newsweek ranking of fellowship-affiliated hospitals (P = .906), Doximity ranking of fellowship-affiliated residencies (P = .703), and region of the United States (P = .126). There was a statistically significant increase in total lifetime earnings in programs with 4 fellows as compared to 1 fellow (P = .035). Conclusion: There was no statistically significant correlation between a variety of foot and ankle fellowship-specific factors and lifetime industry earnings, aside from increased earnings in programs having 4 fellows. Prestige factors, such as Doximity and Ranked Hospital Newsweek List rank, as well as region of the United States is not associated with industry earnings. Level of Evidence: Level III, retrospective cohort study.

Background: A recent study demonstrated that discrepancies exist between disclosures reported by authors publishing in The American Journal of Sports Medicine and disclosures listed in the Physician Payments Sunshine Act–initiated Open Payments database, managed by the Centers for Medicare & Medicaid Services (CMS). However, no study to date has explored the relationship between the biopharmaceutical and device industry (industry) and the membership base of the American Orthopaedic Society for Sports Medicine (AOSSM). Purpose: To critically examine the relationship between orthopaedic sports medicine surgeons and industry. Study Design: Cross-sectional study. Methods: The publicly available CMS Open Payments database website was accessed to search for sports medicine orthopaedic surgeons in the United States who were members of the AOSSM. Financial data, specifically general, research, and ownership payments for 2015, were recorded for each surgeon. The American Academy of Orthopaedic Surgeons (AAOS) disclosures of each surgeon were then obtained. Descriptive statistics and simple proportions were calculated to summarize the collected data, including years in practice and amount of payment. Median values for general payments were compared to provide a more accurate reflection of payments transferred to a “typical” sports medicine surgeon. Results: A total of $58,113,561 in general payments, $3,996,051 in research payments, $72,481,814 in money invested, and $144,552,383 in interest earned from money invested were identified as being paid to 2274 surgeons (all amounts in US$). The distribution of total general payments received was skewed: 10% of surgeons received 95.4% ($55,463,183) of the total general payments. A total of 1433 surgeons had completed, up-to-date AAOS disclosures. Although 44% (635 surgeons) self-reported no financial conflict to the AAOS, the Open Payments database indicated some level of industry support to these surgeons. Unreported general payments totaled $1,393,212, or a median of $561 per surgeon (interquartile range, $10-$200,048). Conclusion: Although orthopaedic sports medicine surgeons received substantial payments from industry, most of the total general payments were given to a small proportion of people. The regional distribution of these payments did not differ significantly. Summary reports of data are largely skewed by outliers and should be interpreted with caution. However, a large percentage of these surgeons failed to reveal industry support of any kind in their AAOS disclosures, including meals and educational funding, demonstrating the importance of transparency and accuracy when completing financial disclosures.