Trends in Industry Payments to Medical Oncologists in the United States Since the Inception of the Open Payments Program, 2014 to 2019

This cohort study of medical oncologists in the US examines trends in physician-level payments in 2014 to 2019 to determine if implementation of the Open Payments program is associated with changes in the frequency and value of industry-oncologist payments. Importance Given the potential for undue influence of industry-physician payments on oncology care, it is important to understand how a national transparency program may be associated with financial interactions between industry and medical oncologists. Objective To identify trends in industry payments to medical oncologists from 2014 to 2019 and determine if the implementation of the Open Payments program is associated with changes in the frequency or value of payments or any shift in the nature of industry-oncologist financial interactions. Design, Setting, and Participants This retrospective, population-based, observational cohort study analyzed Open Payments reports of industry payments made in 2014 to 2019 to a cohort of licensed medical oncologists practicing in the US in 2014, using data from the National Plan and Provider Enumeration System. Exposures Receipt of an industry payment from January 1, 2014, to December 31, 2019. Main Outcomes and Measures General industry payments to medical oncologists, including the proportion receiving payments, total annual value and number of payments, and average annual trends over time, by aggregate value and by nature-of-payment category. Trends over time were analyzed using linear regression and generalized estimating equations. Results In 2014 to 2019, there were 15 585 medical oncologists who received a total of 2.2 million industry payments with a total value of $509 million. The absolute number of oncologists receiving payments decreased from 10 498 in 2014 to 8918 in 2019 (-15.1%). The annual per-physician payment value decreased among those receiving less than $10 000 in aggregate by -3.2% yearly (95% CI, -4.1% to -2.3%; P < .001), but increased for those receiving more than $10 000. Payments increased for consulting (13.7%; 95% CI, 12.4%-15.0%; P < .001) and for entertainment, meals, travel or lodging, and gifts (0.8%; 95% CI, 0.1%-1.5%; P = .03). Conclusions and Relevance The number of medical oncologists accepting industry payments has decreased; however, high-value industry payments have been consolidated in a relatively small number of medical oncologists accepting higher payment values over time. The nature of payments has shifted toward consulting. These findings highlight the limitations of transparency without accountability. Question Was the initiation of the Open Payments program associated with changes in financial interactions between medical oncologists and industry in 2014 to 2019? Findings From 2014 to 2019, a cohort of 15 585 US medical oncologists became less likely to receive industry payments, but the overall value of the payments increased. Over time, medical oncologists receiving lower-value payments (<$10 000) accepted smaller amounts and those receiving higher-value payments (>$10 000) accepted larger amounts. Meaning The trend in industry payments to medical oncologists since the inception of the Open Payments program highlights the limitations of transparency without accountability in policy making.

Automated summary

From 2014 to 2019, a cohort of 15,585 US medical oncologists became less likely to receive industry payments, but the overall value of the payments increased. Over time, medical oncologists receiving lower-value payments (<$10,000) accepted smaller amounts and those receiving higher-value payments (>$10,000) accepted larger amounts. The trend in industry payments to medical oncologists since the inception of the Open Payments program highlights the limitations of transparency without accountability in policy making.