Open Payments Database: Anti–Vascular Endothelial Growth Factor Agent Payments to Ophthalmologists

Singh, Nakul; Chang, Jonathan S.; Rachitskaya, Aleksandra

doi:10.1016/j.ajo.2016.09.026

Cited by 19 publications

(31 citation statements)

References 16 publications

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“…A growing literature documents the importance of these relationships on physician prescribing: specifically, more total prescribing and more prescribing of expensive medications in particular. [1][2][3][4][5][6][7][8][9] To be sure, grants and contractually defined consulting relationships can have beneficial effects on patient care by fostering innovations in drug discovery and technology. However, other common relationships, including speakers' bureaus and token consulting arrangements, may promote activities of questionable medical benefit by favoring industry's interests over those of patients, such as by promoting brand-name drug prescriptions and use of new devices and tests with uncertain value to patients.…”

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confidence: 99%

Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

et al. 2019

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Beside the goal of increasing transparency to the public, disclosure policies and laws have been established with a goal to also reduce ethically questionable financial relationships between physicians and the medical industry. Data on these relationships should be reviewed to understand the association between these policies and laws and the attainment of reduced relationships. OBJECTIVE To assess whether disclosure policies and laws have been associated with a decrease in financial disclosure reporting by physicians. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study uses yearly data from 2008 through 2015 from the participants in the American Academy of Ophthalmology's Annual Meeting. Trends in financial disclosures over time were investigated for the association of disclosure policies and laws with potentially beneficial, as well as ethically questionable physician-industry ties. Linear regression models were used to estimate the annual change in financial disclosures and are reported with 95% CIs. EXPOSURES Disclosure policies and laws. MAIN OUTCOMES AND MEASURES The annual aggregate financial disclosures by type (ie, consultant, lecturer, employee, grant support, equity owner, patent holder). RESULTS Financial disclosures increased from 3966 in 2008 to 5266 in 2015 (P < .001). The number of disclosures reported in the categories consultant, equity owner, patents, and grant support all increased from 2008 to 2015 (consultant disclosures, 121 [95% CI, 88-155] per year; P < .001; equity owner disclosures, 32 [95% CI, 22-42] per year; P < .001; patent disclosures, 19 [95% CI, 13-26] per year; P < .001; grant support disclosures, 78 [95% CI, 48-107] per year; P < .001), while the employee and lecturer categories did not change significantly. The percentage of financial disclosures in the lecturer category decreased relative to the total (estimate, −1.1% [95% CI, −1.3% to −0.8%] per year; P < .001), owing to the number of financial disclosures for this category remaining stable while most other types increased. CONCLUSIONS AND RELEVANCE Disclosure was not associated with a chilling effect (decrease in financial disclosures associated with potentially beneficial physician-industry ties). Disclosure was associated with a possible disinfecting effect, whereby the percentage of ethically questionable disclosures (ie, lecturers) decreased, although the frequency remained stable. A permissive effect (physicians becoming more inclined to having industry relationships) was also observed. Thus, disclosure rules should be enhanced or alternative approaches to disclosure reconsidered to promote a decrease in ethically questionable relationships.

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confidence: 99%

Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

et al. 2019

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“…Many academic publications and general media outlets have focused on the ways that the pharmaceutical industry can impact prescribing, 21 disease definitions, 22 healthcare expenditures, 23 and medical education. 24,25 In ophthalmology, industry payments have been shown to impact VEGF prescribing; 8,9 however, a study of ophthalmology residents showed that while the majority of trainees interact with pharmaceutical representatives, these trainees commonly feel that they are not susceptible to the influence of pharmaceutical promotions. 26 This discrepancy suggests that clinicians may be subconsciously influenced by industry contributions, and warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7] In the field of ophthalmology, industry payments have been associated with distinct patterns in prescribing of antivascular endothelial growth factor (VEGF) agents, prompting questions about the impact of these payments on ophthalmologists. 8,9 To broaden the understanding of industry payments to ophthalmologists, we conducted a comprehensive analysis of Open Payments data for every academic ophthalmologist in the United States, examining associations between industry support and scholarly impact. We also analyzed the influence of subspecialty, gender, academic rank, type of degree, and additional degree(s) (e.g., MBA, MPH) on scholarly output.…”

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confidence: 99%

Association between Industry Payments and Scholarly Impact among Academic Ophthalmologists

et al. 2019

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Purpose The aim of this article is to examine the association between industry payments to ophthalmologists and scholarly impact. Design Retrospective cross-sectional study. Methods All ophthalmology faculty at United States accredited ophthalmology residency programs were included in this study. The main exposure was industry payments to ophthalmologists in 2016, as reported in the Centers for Medicare and Medicaid Services Open Payments Database. The primary outcome was Hirsch index (H-index), a measure of scholarly impact. Results Among 1,653 academic ophthalmologists in our study, 1,225 (74%) received industry payments in 2016. We did not observe a difference between the mean H-index of ophthalmologists receiving any industry payments versus those not receiving any payments (p = 0.68). In analysis including only ophthalmologists who received industry payments, H-index differed significantly by payment amount: 12.6 for ophthalmologists receiving less than $100, 12.2 for those receiving $100 to 1,000, 18.8 for those receiving $1,000 to 10,000, 21.3 for those receiving $10,000 to 100,000, and 29.4 for those receiving greater than $100,000 (p < 0.001). Within each academic rank and gender, industry payments greater than $1,000 were associated with a higher H-index (p < 0.05). Conclusions Although our analysis cannot prove causality, we observed a significant association between industry payments and scholarly impact among academic ophthalmologists, even after adjusting for gender, academic rank, and subspecialty. Prospective studies should further evaluate this relationship.

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“…The You&i program 55 for ibrutinib aimed to remove the 140 mg capsule from the market, limiting dosing flexibility, while pricing newly introduced tablet formulations (140-560 mg) at 3 times the price REVIEW of the 140 mg capsule. Other strategies include paying physicians to prescribe on-label, 56 opposing experts who study dose de-escalation, or legal or regulatory action to discourage IVPE practices.…”

Section: Pharmaceutical Opposition To Ivpe Studiesmentioning

confidence: 99%

Interventional Pharmacoeconomics: A Novel Mechanism for Unlocking Value

Serritella

Strohbehn

Goldstein

et al. 2020

Clin Pharma and Therapeutics

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Cancer care’s sustainability is challenged by drug expenditures. In the absence of systemic change, innovation is needed to curtail drug costs. Interventional pharmacoeconomics (IVPE) utilizes clinical research to identify safe, efficacious, cost‐conscious dosing regimens to extract maximum value from expensive therapies. Strategies include de‐escalation of dosage, treatment duration and administration frequency, and substitution with therapeutic alternatives. In this review, we discuss how IVPE strategies have been successfully used and could be implemented going forward.

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Open Payments Database: Anti–Vascular Endothelial Growth Factor Agent Payments to Ophthalmologists

Cited by 19 publications

References 16 publications

Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

Association between Industry Payments and Scholarly Impact among Academic Ophthalmologists

Interventional Pharmacoeconomics: A Novel Mechanism for Unlocking Value

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