scholarly journals Conflicts of Interest of Pediatric Journal Authors

Author(s):  
Rebecca L Petlansky ◽  
Amadea D Bekoe-Tabiri ◽  
Vanessa N Bueno ◽  
AnnMarie N Onwuka ◽  
Michael R Gionfriddo ◽  
...  

The Physician Payments Sunshine Act requires disclosure of payments made by drug and medical device manufacturers to physicians or teaching hospitals. Academic literature extensively documents gender disparities in the medical profession with regard to salary, promotion, and government funded research. This investigation sought to quantify potential conflicts of interest (CoIs) in pediatric medical journals, specifically examining sex differences. To identify potential CoIs, we examined manuscripts published prior to 2019 in six pediatric journals (JAMA Pediatrics, Pediatrics, The Journal of Pediatrics, Pediatric Blood and Cancer, Pediatric Critical Care Medicine, and The Pediatric Infectious Disease Journal). We collected physician demographics and specialty from the National Plan and Provider Enumeration System National Provider Identifier Registry and compensation data from both ProPublicas Dollars for Docs (PDD) and Centers for Medicare and Medicaid Services Open Payments (CMSOP). Data was collected on 2,747 authors from 929 manuscripts. Of the 1,088 authors based in the United States with medical degrees (40.5% female), 510 (46.9%) had entries in PDD and CMSOP. Overall, 11,791 payments to these physician-authors totaled $9,586,089.97. Males were 19.6% more likely to receive payments (RR = 1.20, 95% CI [1.05, 1.37], p = 0.008). The mean amount received by males was $23,250.71 while that received by females was $10,970.78 (mean difference = 12,279.92, 95% CI = (2036.31, 22,523.54), p = 0.019). A comprehensive understanding of these CoIs can inform the disclosure policies of journals to promote transparency of authors.

Author(s):  
Rowland W Pettit ◽  
Jordan Kaplan ◽  
Matthew M Delancy ◽  
Edward Reece ◽  
Sebastian Winocour ◽  
...  

Abstract Background The Open Payments Program, as designated by the Physician Payments Sunshine Act is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization. Objectives We sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation. Methods The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution. Results 61,000,728 unique payments totaling $11,815,248,549 were identified over the six-year study period. 9,089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (p=0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (p = 0.0840). Cash and cash equivalents proved to be the most common form of payment; Stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014-2019 (mean $ 76,420.75). California had the greatest number of plastic surgeons to receive payments (1,452 surgeons). Conclusions Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past six years, geographic trends in industry payments have remained stable.


Neurology ◽  
2019 ◽  
Vol 92 (21) ◽  
pp. 1006-1013 ◽  
Author(s):  
Aditi Ahlawat ◽  
Pushpa Narayanaswami

ObjectiveTo analyze research and nonresearch payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services (CMS) Open Payments Database.MethodsIn this retrospective database analysis, we computed the percentage of neurologists in the United States receiving payments, the median/mean payments per neurologist, payment categories, regional trends, and sponsors. We computed the number of practicing neurologists from the Association of American Medical Colleges State Physician Workforce Data Book, 2015.ResultsIn 2015, approximately 96% of US neurologists received nonresearch payments totaling $93,920,993. The median payment per physician was $407. The highest proportion of neurologists (24%) received between $1,000 and $10,000. Food and beverage was the most frequent category (83% of the total number of payments). The highest amount was paid for serving as faculty/speaker for noncontinuing medical education activities (49%). The top sponsor of nonresearch payments was Teva Pharmaceuticals ($16,461,055; 17.5%). A total of 412 neurologists received $2,921,611 in research payments (median $1,132). Multiple sclerosis specialists received the largest proportion ($285,537; 9.7%). Daiichi Sankyo paid the largest amount in research payments ($826,029; 28%).ConclusionsThe Open Payments program was established to foster transparent disclosure of physician compensations from industry, in response to legislative and public concerns of the effect of conflicts of interest on practice, education, and research. The effects of this program remain unclear and studies of changes in prescribing practices, costs, and other outcomes are necessary. CMS should ensure that incorrect information can be rectified quickly and easily.


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1127-1127 ◽  
Author(s):  
Lauren Westfall Veltri ◽  
Aaron Cumpston ◽  
Alexandra Shillingburg ◽  
Christopher Lipinski ◽  
Sijin Wen ◽  
...  

Abstract HPC mobilization with plerixafor (Plex) plus G-CSF (G+P) results in superior CD34+ cell yield, when compared to mobilization with G-CSF alone in patients with myeloma and lymphoid malignancies. However, Plex-based approaches are associated with high mobilization costs. To circumvent higher costs, several institutions use a so-called JIT approach, where Plex is only administered to patients likely to fail mobilization with G-CSF alone. Whether such a JIT-Plex approach is cost effective has not been confirmed to date. We present here, a single institution comparative analysis of 137 patients with myeloma and lymphoma who underwent mobilization with 2 different approaches of Plex utilization. Between Jan 2010-Oct 2012 (n=77) patients received mobilization G-CSF (10 μg/kg) for 5 days and Plex (0.24 mg/kg) on the evening of day four, 11 hours before apheresis the following day (G+P). To reduce mobilization costs between Nov 2012-Jun 2014 (n=60) patients were mobilized with JIT-Plex where Plex was only administered to patients likely to fail mobilization with G-CSF alone (i.e. patients with a day 4 peripheral blood (PB) CD34+ count of <10/μL, or those with day 1 yield of < 1.0 X 106 cells/kg or day 1+2 yield of <1.5 X 106 cells/kg ABW. Mobilization failure was defined as inability to collect at least 2 X 106 /kg CD 34+ cells. Patients in G+P had a higher mean peak PB CD34+ cell count (77 vs. 33.1 cells/μL, p<0.001) and a higher mean CD34+ cell yield on day 1 of collection (4.4 X 106 vs. 2.4 X 106 cells/kg ABW, p=0.0005). The mean total CD34+ cell collection was also higher in G+P (6.64 X 106 vs. 4.81 X 106 cells/kg ABW, p=0.0068). In the JIT-Plex group 41% (n=24) completed adequate HPC collection without Plex. Mobilization failure was noted in 5 patients in the G+P group (3 were salvaged with bone marrow harvest) and 2 patients in the JIT-Plex group. Two patients in either group did not proceed to AHCT as a result of mobilization failure. The mean Plex doses utilized in JIT-Plex was lower (1.3 vs. 2.1, p=0.0002), however 21% (n=16) in the G+P group completed apheresis on day 1 compared to only 6.9% (n=4) in JIT-Plex, p=0.0094. Cost analysis was estimated based on actual sales price (actual wholesale price AWP – (AWP X 0.2)) for mobilization agents and the United states (US) Department of Health and Human Services Centers for Medicaid Services (HHS/CMS) reimbursement rates for procedural costs associated with mobilization, apheresis or cryopreservation. The mean estimated cost was higher in the G+P group ($28,448 vs. $24,852, p=0.0315). Our analyses, for the first time confirms that mobilization with JIT-Plex allows for a safe, adequate and cost efficient strategy for HPC collection. Baseline Patent Characteristics at Time of Mobilization Table Mobilization Strategy Upfront Plerixafor + G-CSF (n=77) G-CSF + Just-in-time Plerixafor (n=60) p-value Disease Myeloma Lymphoma 46 (60%) 31 (40%) 30 (50%) 30 (50%) 0.29 Mean age, years (range) 58 (23-75) 57 (22-75) 0.45 Male gender 42 (55%) 33 (57%) 0.92 Race: Caucasian 73 (97%) 57 (98%) 1.0 Lines of prior therapy, mean 1.5 1.8 0.3 Prior Radiation 13 (18%) 12 (21%) 0.66 Mean KPS (range) 80 (70-100) 80 (60-100) 0.75 HCT-CI Score (mean) 2 2 0.36 Abbreviations: G-CSF-granulocyte-colony stimulating factor (filgrastim); KPS-Karnofsky performance status; HCT-CI- hematopoietic cell transplantation-specific comorbidity index Disclosures No relevant conflicts of interest to declare.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6520-6520
Author(s):  
Deborah Catherine Marshall ◽  
Elizabeth Stieglitz Tarras ◽  
Kenneth Rosenzweig ◽  
Deborah Korenstein ◽  
Susan Chimonas

6520 Background: Industry-physician financial relationships in medical oncology are common and introduce conflicts of interest. The Open Payments (OP) program collects and discloses data on industry payments to physicians, in part to discourage inappropriate relationships. However, the effect of OP on how oncologists engage with industry is unknown. Our aim was to evaluate trends in physician-level payments to test whether the implementation of OP has resulted in fewer physicians engaging with industry and has shifted the nature of interactions towards those considered more appropriate. Methods: We performed a retrospective cohort study of US medical oncologists in 2014 from the National Plan and Provider Enumeration System. OP data for general (non-research) payments between 2014-2017 were matched to physician to evaluate receipt of payments over time. We calculated the percentage of physicians receiving payments, annual value and number of payments, and average annual trends over time, including by nature of payment. Results: From 2014-2017, medical oncologists received 1.4 million industry payments totaling $330.6 million. The absolute number of medical oncologists receiving payments decreased 4% on average annually ( P= .006), and proportionally from 67.2% to 59.6% overall. The value and number of payments have not significantly changed. The value and number of payments increased for accredited/certified CME (+821% and +209% annually) and decreased for non-accredited/certified CME (-18% and -25% annually). The value and number of food/beverage payments remained the same. The value and number of royalty/licensing payments increased. Conclusions: Fewer oncologists are receiving payments, but spending has not decreased suggesting that physicians are less likely to engage and industry is more selective. Increased payments for accredited CME suggest that less appropriate speaker’s fees are being avoided. Food/beverage payments are not decreasing, thus these interactions may not be recognized as problematic. Increasing royalty/licensing payments require ongoing scrutiny. Changes in physician payments since the inception of OP highlight the importance of transparency in policymaking.


Author(s):  
MP de Lotbiniere-Bassett ◽  
PJ McDonald

Background: The 2013 Physician Payments Sunshine Act mandates that all US drug and device manufacturers disclose payments to physicians annually in the Open Payments Database (OPD). We aimed to determine the prevalence, magnitude and nature of these payments to neurological surgery in 2015. Methods: Records of payments to physicians identified by the ‘neurological surgery’ taxonomy code in 2015 were accessed via the OPD. The data were analyzed in terms of the type and amounts of payments, companies making payments, and in comparison to previous studies. Results: In 2015, 330 companies made 83,690 payments ($99,048,607) to 7,613 physicians. The mean payment ($13,010) was substantially greater than the median ($114). Royalties and licensing accounted for the largest proportion of total payment value (74.2%), but only 1.7% of the total number. Food and beverage payments were the most commonly reported transaction (75%), but only 2.5% of the total value. Neurological surgery had the second highest average total payment per physician of any specialty. Conclusions: The overall value of payments to the neurological surgery specialty is driven by a small number of payments that may represent appropriate compensation for novel device development. The OPD provides an opportunity for increased transparency and for the interpretation of research in light of potential conflicts of interest.


Author(s):  
Grace Ha ◽  
Rachel Gray ◽  
Mona Clappier ◽  
Neil Tanna ◽  
Armen K. Kasabian

Abstract Background Industry relationships and conflicts of interest can impact research funding, topics, and outcomes. Little research regarding the role of biomedical companies at microsurgery conferences is available. This study evaluates the role of industry at conferences by comparing payments received by speakers at the American Society for Reconstructive Microsurgeons (ASRM) meeting with those received by speakers at the American Society of Aesthetic Plastic Surgeons (ASAPS) meeting, the American Society of Plastic Surgeons (ASPS) meeting, and an average plastic surgeon. It also compares payments made by different companies. Methods General payments received by speakers at the 2017 ASAPS, ASPS, and ASRM conferences were collected from the Open Payments Database. Mean payments received at each conference were calculated and the Mann–Whitney U test evaluated differences between conference speakers and the average plastic surgeon. The total amount of payments from each company was collected through the Open Payments Database, and Z-tests identified which companies paid significantly more than others. Results The mean (and median) general payments made to conference speakers at ASAPS (n = 75), ASPS (n = 247), and ASRM (n = 121) were $75,577 ($861), $27,562 ($1,021), and $16,725 ($652), respectively. These payments were significantly greater (p < 0.001 for all) than those of the average plastic surgeon ($4,441 and $327), but not significantly different from each other. Allergan contributed significantly more than other companies to speakers at ASPS and ASAPS, while LifeCell Corporation, Zimmer Biomet Holdings, and Axogen contributed significantly more to speakers at ASRM. Conclusion Payments to physicians at ASRM were significantly higher than those of an average plastic surgeon but not significantly different from those of speakers at ASAPS and ASPS. Certain companies paid significantly more than their peers at each conference. Given these findings, speakers should strive to make clear the nature and extent of their conflicts of interest when presenting at conferences.


Neurology ◽  
2018 ◽  
Vol 90 (23) ◽  
pp. 1063-1070 ◽  
Author(s):  
Aditi Ahlawat ◽  
Pushpa Narayanaswami

ObjectiveTo analyze research and nonresearch payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services (CMS) Open Payments database.MethodsIn this retrospective database analysis, we computed the percentage of neurologists in the United States receiving payments, the median/mean payments per neurologist, payment categories, regional trends, and sponsors. We computed the number of practicing neurologists from the Association of American Medical Colleges State Physician Workforce data book, 2015.ResultsIn 2015, approximately 51% of US neurologists received nonresearch payments totaling $6,210,414. The median payment per physician was $81. Payments to the top 10% of compensated neurologists amounted to $5,278,852 (84.5%). Food and beverage was the most frequent category (86.5% of the total number of payments). The highest amount was paid for serving as faculty/speaker for noncontinuing medical education activities (58%). The top sponsor of nonresearch payments was Teva Pharmaceuticals ($1,162,900; 18.5%). A total of 412 neurologists received $2,921,611 in research payments (median $1,132). Multiple sclerosis specialists received the largest proportion ($285,537; 9.7%). Daiichi Sankyo paid the largest amount in research payments ($826,029; 28%).ConclusionsThe Open Payments program was established to foster transparent disclosure of physician compensation from industry, in response to legislative and public concerns over the effect of conflicts of interest on practice, education, and research. The effects of this program remain unclear and studies of changes in prescribing practices, costs, and other outcomes are necessary. CMS should ensure that incorrect information can be rectified quickly and easily.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Isath ◽  
S Perembeti ◽  
A Correa ◽  
A Chahal ◽  
D Padmanabhan ◽  
...  

Abstract Background Orthotopic heart transplant (OHT) is indicated for end-stage heart failure due to cardiac sarcoidosis (CS). However, utilization of OHT for CS has been controversial due to concern for involvement of other organs by sarcoidosis affecting long term outcomes. Purpose Our objective was to study the trends in OHT in patients with CS in the United States using Healthcare Cost and Utilization Project (HCUP) National (nationwide) Inpatient Sample (NIS) from 1999 to 2014. Methods Using NIS data, we identified patients older than 18 years with cardiac sarcoidosis using codes ICD 9-CM codes of 135 and 425.8. Among these patients, we identified those who underwent cardiac transplantation using ICD 9-CM procedure codes 37.5 and 33.6. We presented categorical data as percentages and continuous data as mean or median as appropriate. Results A weighted total of 24231 hospitalizations for CS was extracted from 1999 to 2014 of which 248 (1.02%) CS patients underwent OHT. The trends in cardiac transplant for CS is as shown in Figure 1. The mean age of CS patients undergoing OHT was 51.7±1.1 years and 60.4% (n=150) were males. 114 (45.9%) were Caucasians and 27.8% (n=25) were African-American. 100% of the transplants were performed at medium (n=5) or large sized (n=243) teaching hospitals and 97.9% of cardiac transplants were also done at teaching hospitals. Heart transplants were mostly done in the South (36.3%) followed by Midwest (26.2%), West (25%) and Northeast (12.5%). Private insurance was the major payor source which covered 149 (60.1%) patients followed by Medicare covering 65 (26.2%) patients. A total of 10 (3.9%) cardiac sarcoidosis patients died during the same hospitalization for cardiac transplantation. Following OHT, 84.2% (n=209) were discharged home and 11.6% (n=29) to short term hospitalization. The mean cost of hospitalization for OHT in CS when adjusted for inflation was 535144±56060 dollars while the average length of stay for heart transplant for CS was 46.2±6.6 days. Conclusions Cardiac transplant trends in CS have not changed from 1999 to 2014 despite recent studies showing improved outcomes and are associated with substantial cost of hospitalization and length of stay. Majority of cardiac transplant was done in Caucasians despite cardiac sarcoidosis being more common in African-Americans. Funding Acknowledgement Type of funding source: None


Dear Sir,—I had the pleasure to receive your letter of Aug. 3rd by the last monthly steamer from the north, and greatly lamented I could not answer it by the mail, which left Dec. 30th. Leaving the United States on the 16th of August, want of a proper amount of fire surface in the boilers of the steam-ship, caused my arrival at Chagres only on the day (27th) when the mail for Chile left. A month was thus unavoidably lost; for in anticipation of a passage through without delay, all instruments, except an aneroid barometer and thermometer, had been despatched round Cape Horn. With these such observations were made, until arrival here, as their construction permitted. From the indications of the aneroid there is a region extending from 200 miles to the S. S. W. of San Domingo to about 1° of north latitude on this side of the continent, where the pressure rarely exceeds 29·850 in., nor was the barometer but once in that whole distance as high as 29·900 in. At Panama the mean is 29·795 in. from observations at 9 a.m., 3 p.m., and 9 p.m., with a mean diurnal fall from the first to the second hours of ·08 in. The temperature for the same hours was 81°·0 with a range of 2°·9, and almost constantly saturated with moisture, though rain fell no more frequently than often occurs during the same period in the United States. As evidence of the hygrometric condition of the atmosphere, it was found impossible to dry clothing in my room after several days’ open exposure, and they were finally exposed to the direct rays of the sun. Leather moulds in forty-eight hours. The light wind experienced was almost constantly from the northward and westward during the day, and variable at night. I think Lieut.-Col. Emery made observations for declination and dip en route for California, but nothing is known to me of the results, and I must await our return to give you data on these points. Should nothing intervene to change present intentions, I contemplate making observations at each of the fifteen ports where the steamer touches between Valparaiso and Panama. Nothing of note occurred during our passage to Chile. There was time to glance at Buonaventura, Guyaquil, Payta, Huanchaco (part of Truxillo), Casma, five days at Lima, Pisco, Islay, Arica, Iquique, Coleiga, Copiapo and Coquimbo,—a multitude of little towns unimportant in themselves, and mentioned only to indicate the points where I hope to obtain observations of the magnetic elements. Reaching Santiago on the 27th of October, I was convinced in a brief time that no other part of Chile would so well answer the purposes of the expedition, and the Government here having acted promptly and with most commendable liberality on all points, there was no hesitation in selecting this city as my station. You know it is situated on a plain varying in width from twelve to forty miles, which, commencing just north of 33°, with a slight interruption in 34½°, extends to the Gulf of Onend in 41½°. The sea range of the Cordilleras, from which Santiago is distant from four to five leagues, has an elevation of 3000 to 4000 feet above the ocean, whilst the main chain to the eastward varies from 10,000 to 17,000 or 18,000 feet, and is distant about six leagues at the base. Interrupting the eastern horizon as they do, the interference with observations on the planet Venus in the morning twilight rendered so near an approach objectionable; but there was no locality in the vicinity of a proper residence free from this obstacle, and no place in the interior offering the facilities possessed by Santiago. If I mistake not, in one of my former letters I stated that the coast was impracticable, on account of very frequent fog and mist; and this was the opinion of the most observant residents here. There were two positions offered for our use by the Government,—a hill (Santa Lucia) in the eastern part of the city, with such rooms in the Castle, about halfway up, as might be needed, and the plain in the southern suburbs. The former has an elevation of some 200 feet, whilst the latter is half submerged during the rainy season, and almost inaccessible to pedestrians. Many reasons inclined me to prefer Santa Lucia, could its rocky crest be leveled, and this the Government at once undertook.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252656
Author(s):  
Raphael E. Cuomo ◽  
Mingxiang Cai ◽  
Neal Shah ◽  
Tim K. Mackey

The Open Payments database reports payments made to physicians by industry. Given the potential for financial conflicts of interest relating to patient outcomes, further scrutiny of these data is valuable. Therefore, the objective of this study was to analyze physician-industry relationships by specialty type, payment type, geospatial trend, and longitudinal trend between 2014–2018. We conducted an observational, retrospective data analysis of payments from the Open Payments database for licensed United States physicians listed in the National Plan & Provider Enumeration System (NPPES). Datasets from 2013–2018 were joined using the Python programming language. Aggregation and sub-setting by characteristics of interest was done in R to calculate means and frequencies of reported general physician payments from industry across different specialties, locations, timeframes, and payment types. Normalization was applied for numbers of physicians or payments. Geospatial statistical hot spot analysis was conducted in ArcGIS. 51.73 million payment records were analyzed. In total, 50,047,930 payments were issued to 771,113 allopathic or osteopathic physicians, representing $8,702,631,264 transferred from industry to physicians over the five-year period between 2014 and 2018. The mean payment amount was $179, with a standard deviation of $12,685. Variability in physicians’ financial relationships with industry were apparent across specialties, regions, time, and payment type. A limited match rate between records in the NPPES and Open Payments databases may have resulted in selection bias of trends related to physician characteristics. Further research is necessary, particularly in the context of changing industry payment trends and public perceptions of the appropriateness of these relationships.


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