scholarly journals Increasing Financial Payments From Industry to Medical Oncologists in the United States, 2014–2017

2021 ◽  
pp. 1-9
Author(s):  
Mohammed W. Rahman ◽  
Niti U. Trivedi ◽  
Peter B. Bach ◽  
Aaron P. Mitchell
Keyword(s):  
Clinical Practice ◽  
Pharmaceutical Industry ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Guideline Development ◽  
Temporal Trends ◽  
The United States ◽  
Nccn Guidelines ◽  
Medical Oncologists

Background: Personal payments from the pharmaceutical industry to US physicians are common and are associated with changes in physicians’ clinical practice and interpretation of clinical trial results. We assessed temporal trends in industry payments to oncologists, with particular emphasis on payments to authors of oncology clinical practice guideline and on payments related to immunotherapy drugs. Methods: We included US physicians with active National Plan and Provider Enumeration System records and demographic data available in the Centers for Medicare & Medicaid Services Physician Compare system who had a specialty type of medical oncology or general internal medicine. Medical oncologists serving on NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panels were identified manually. Industry payments, and the subset associated with PD-1/PD-L1 drugs, were identified in Open Payments, the federal repository of all transactions of financial value from industry to physicians and teaching hospitals, from 2014 to 2017. Results: There were 13,087 medical oncologists and 85,640 internists who received payments. The mean, annual, per-physician value of payments to oncologists increased from $3,811 in 2014 to $5,854 in 2017, and from $444 to $450 for internists; the median payment increased from $152 to $199 for oncologists and remained at $0 for internists. Oncologists who served on NCCN Guidelines Panels received a greater value in payments and experienced a greater relative increase: mean payments increased from $10,820 in 2014 to $18,977 in 2017, and median payments increased from $500 to $1,366. Among companies marketing PD-1/PD-L1 drugs, mean annual per-oncologist payments associated with PD-1/PD-L1 drugs increased from $28 to $773. Total per-oncologist payments from companies marketing PD-1/PD-L1 drugs experienced a 165% increase from 2014 to 2017, compared with a 31% increase among similar companies not marketing PD-1/PD-L1 drugs. Conclusions: Pharmaceutical industry payments increased for US oncologists from 2014 to 2017 more than for general internists. The increase was greater among oncologists contributing to clinical practice guidelines and among pharmaceutical companies marketing PD-1/PD-L1 drugs. The increasing flow of money from industry to US oncologists supports ongoing concern regarding commercial interests in guideline development and clinical decision-making.

International Adaptation and Use of NCCN Guidelines

2014 ◽  
Vol 12 (5S) ◽  
pp. 838-841 ◽  
Author(s):  
Ali Bazarbachi ◽  
Andrew D. Zelenetz
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
B Cell Lymphoma ◽  
The United States ◽  
Annual Conference ◽  
Nccn Guidelines ◽  
Adult T Cell Leukemia ◽  
Large B Cell Lymphoma ◽  
Modification Process

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) describe a continuum of cancer care in the United States, from initial diagnosis through treatment and referral to hospice beyond treatment. However, in many other countries, there are no regional or national clinical practice guidelines. In 2008, the NCCN-MENA (Middle East and North Africa) project was launched to adapt the NCCN Guidelines to this part of the world. During their joint presentation at the NCCN 19th Annual Conference, Dr. Ali Bazarbachi and Dr. Andrew D. Zelenetz explored the modification process of NCCN Guidelines for MENA and shared examples of how it improved the care of patients with adult T-cell leukemia or lymphoma and younger patients with diffuse large B-cell lymphoma—regardless of where they live.

scholarly journals Acute Myeloid Leukemia, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

2019 ◽  
Vol 17 (6) ◽  
pp. 721-749 ◽  
Author(s):  
Martin S. Tallman ◽  
Eunice S. Wang ◽  
Jessica K. Altman ◽  
Frederick R. Appelbaum ◽  
Vijaya Raj Bhatt ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
The United States ◽  
Nccn Guidelines ◽  
Younger Age ◽  
Acute Myeloid

Acute myeloid leukemia (AML) is the most common form of acute leukemia among adults and accounts for the largest number of annual deaths due to leukemias in the United States. Recent advances have resulted in an expansion of treatment options for AML, especially concerning targeted therapies and low-intensity regimens. This portion of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for AML focuses on the management of AML and provides recommendations on the workup, diagnostic evaluation and treatment options for younger (age <60 years) and older (age ≥60 years) adult patients.

Breast Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (2) ◽  
pp. 148 ◽  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Invasive Breast Cancer ◽  
The United States ◽  
Cancer Society ◽  
Nccn Guidelines ◽  
Recent Version

The American Cancer Society estimates that approximately 205,000 new cases of breast cancer were diagnosed in the United States in the year 2002, and approximately 40,000 patients will die of this disease. The NCCN guidelines discuss the complex and varied therapeutic options for patients with noninvasive or invasive breast cancer. For the most recent version of the guidelines, please visit NCCN.org

The association between drug industry payments and NCCN guideline panel membership.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2068-2068
Author(s):  
Aaron Philip Mitchell ◽  
Akriti A. Mishra ◽  
Pranammya Dey ◽  
Michael A. Curry ◽  
Niti A. Trivedi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Linear Models ◽  
Nccn Guidelines ◽  
Medical Oncologists ◽  
Before And After ◽  
Medical School Graduation ◽  
Open Payments ◽  
Financial Relationships

2068 Background: The high frequency of financial relationships between the pharmaceutical industry and influential oncologists who author clinical practice guidelines may influence guideline recommendations. Therefore, we assessed the financial relationships held by NCCN Guidelines panelists before and after joining the panel, compared to those held by a matched set of oncologists. Methods: Membership of NCCN Guidelines panels for the 20 most common cancers was obtained from archival guidelines and linked manually to Open Payments records of industry payments. We identified physicians who newly joined an NCCN panel during the August 2013-December 2018 study period, and we included medical oncologists who had at least 1 year of Open Payments data before and after joining. These medical oncologists who joined an NCCN panel (panelists) were matched 1:2 to medical oncologists with the same gender, institutional affiliation, and medical school graduation year, who did not join an NCCN panel (non-panelists). The dollar value of industry payments was then calculated over the 1 year before (pre-join) and after (post-join) the date that each panelist joined. We used generalized linear models to assess differences in industry payments between the panelists and matched non-panelists in the pre-join period. We used difference-in-difference estimation (DiD) to assess whether joining an NCCN panel was associated with increased payments in the post-join period. Results: There were 54 panelists and 108 non-panelists (matched from 1447 eligible oncologists at NCCN institutions). Mean per-oncologist payments among panelists were greater than non-panelists in the pre-join period ($11,259 vs $3,427, p = 0.02). From the pre-join to post-join period there was a similar increase in mean per-oncologist payments among panelists and non-panelists ($2,236 vs. $1,569, DiD estimate +$667, p = 0.77). Conclusions: Medical oncologists who were selected to an NCCN Guidelines panel had greater financial ties to industry compared to peer oncologists who were not selected. This difference was present prior to joining; oncologists did not experience a greater increase in financial payments from industry in the 1-year period after joining an NCCN panel. These results suggest an opportunity to reduce the potential influence of industry in oncology clinical practice guidelines through the selection of guideline panelists with fewer ties to industry.

Hepatobiliary Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (1) ◽  
pp. 94 ◽  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Gallbladder Cancer ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
The United States ◽  
Newly Diagnosed ◽  
Nccn Guidelines ◽  
Hepatobiliary Cancer ◽  
Recent Version

Hepatobiliary cancers are both common and highly lethal worldwide. However, in the United States, the incidence of hepatobiliary cancer is relatively low, with approximately 23,700 patients newly diagnosed each year. Gallbladder cancer is the most common of the hepatobiliary malignancies, accounting for approximately 30% of newly diagnosed cases in the United States. Along with summaries of the NCCN guidelines for the 4 subtypes of hepatobiliary cancer, this article includes a brief discussion of the epidemiology, pathology, etiology, staging, diagnosis, and treatment of each subtype. For the most recent version of the guidelines, please visit NCCN.org

scholarly journals Neuroendocrine and Adrenal Tumors, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology

2021 ◽  
Vol 19 (7) ◽  
pp. 839-868
Author(s):  
Manisha H. Shah ◽  
Whitney S. Goldner ◽  
Al B. Benson ◽  
Emily Bergsland ◽  
Lawrence S. Blaszkowsky ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Adrenal Tumors ◽  
Genetic Risk Assessment ◽  
Nccn Guidelines ◽  
Surgical Methods ◽  
Adrenal Gland Tumors

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Neuroendocrine and Adrenal Gland Tumors focus on the diagnosis, treatment, and management of patients with neuroendocrine tumors (NETs), adrenal tumors, pheochromocytomas, paragangliomas, and multiple endocrine neoplasia. NETs are generally subclassified by site of origin, stage, and histologic characteristics. Appropriate diagnosis and treatment of NETs often involves collaboration between specialists in multiple disciplines, using specific biochemical, radiologic, and surgical methods. Specialists include pathologists, endocrinologists, radiologists (including nuclear medicine specialists), and medical, radiation, and surgical oncologists. These guidelines discuss the diagnosis and management of both sporadic and hereditary neuroendocrine and adrenal tumors and are intended to assist with clinical decision-making. This article is focused on the 2021 NCCN Guidelines principles of genetic risk assessment and counseling and recommendations for well-differentiated grade 3 NETs, poorly differentiated neuroendocrine carcinomas, adrenal tumors, pheochromocytomas, and paragangliomas.

scholarly journals Integrating approaches for quality guideline development in LactaMap, an online lactation care support system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melinda Boss ◽  
Jennifer Turner ◽  
Patrick Boss ◽  
Peter Hartmann ◽  
Douglas Pritchard ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Support System ◽  
Practice Guidelines ◽  
Common Sense ◽  
Guideline Development ◽  
Phase 1 ◽  
Domain Score ◽  
Agree Ii ◽  
Care Support

Abstract Background Health professionals caring for women and infants experiencing difficulty with breastfeeding have reported deficiencies in evidence-based lactation knowledge. LactaMap is an online lactation care support system with more than 100 clinical practice guidelines to support breastfeeding care. Clinical practice guidelines support medical decision-making by summarising scientific evidence into systematically developed statements for specific clinical circumstances. Both common-sense and theory-based approaches have been used for guideline development and debate continues regarding which is superior. LactaMap clinical practice guidelines were created over the course of 5 years using a common-sense approach that was refined inductively. The aim of this study was to incorporate a theory-based framework approach into the methodology for ongoing update and review of LactaMap clinical practice guidelines. Methods The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was chosen as the framework-based approach to appraise LactaMap guideline quality. The study was conducted in two phases. The first phase appraised all 103 original LactaMap guidelines. The second phase appraised a subset of 15 updated LactaMap guidelines using improved methodology guided by phase 1, as well as 15 corresponding original (un-updated) guidelines. Results Mean Domain scores for 103 LactaMap original guidelines were above 75% in 3 of the 6 AGREE II quality Domains and no mean Domain score rated poorly. Update of guideline methodology was guided by phase 1 appraisals. Improved documentation of methods relating to questions in the Rigour of Development Domain resulted in improvement in mean Domain score from 39 to 72%. Conclusions This study showed that a theory-based approach to guideline development methodology can be readily integrated with a common-sense approach. Factors identified by AGREE II theory-based framework provided practical guidance for changes in methodology that were integrated prior to LactaMap website publication. Demonstration of high quality in LactaMap clinical practice guideline methodology ensures clinicians and the public can have trust that the content founded on them is robust, scientific and of highest possible quality.

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