Industry Payments to Practicing US Rheumatologists, 2014-2019

Objective Payments from the pharmaceutical industry to practicing physicians may influence prescribing behavior. This study was undertaken to investigate the nature, quantity, and geographic distribution of payments to US rheumatologists. Methods General payments from industry sponsors to US rheumatologists from 2014 to 2019 were extracted from the Centers for Medicare and Medicaid Services Open Payments database. Gender was identified by linking physicians to the National Plan and Provider Enumeration System registry. Data were reported in aggregate, trends over time were assessed using linear regression models, and differences by gender were analyzed using the Wilcoxon rank sum test. Results Over the 6-year time period from 2014 to 2019, a total of 1,610,668 payments totaling $221,254,966 were made to 5,723 rheumatologists. The median payment was $15 (interquartile range [IQR] $10 to $22), and the median total amount received by individual rheumatologists over the 6-year period was $2,818 (IQR $464 to $11,560). The majority of rheumatologists (3,416 of 5,723 [60%]) received less than $5,000, but 368 of 5,723 (6%) received more than $100,000 each and accounted for 78% of the total. The yearly value of payments increased over time ($3,703,264 per year; P < 0.001), and the median payment to male rheumatologists was significantly higher than the median payment to female rheumatologists ($3,723 [IQR $542 to $15,841] versus $2,084 [IQR $394 to $8,186]; P < 0.001). Conclusion The value of industry payments has increased over time, and a large amount is concentrated among a small number of rheumatologists. Future studies should investigate the degree to which industry payments have influenced prescribing in the field of rheumatology.

Automated summary

This study investigated the nature, quantity, and geographic distribution of payments from the pharmaceutical industry to US rheumatologists. Results showed that the majority of rheumatologists received less than $5,000, while a small number received over $100,000 each, accounting for a large portion of the total payments. The value of industry payments increased over time, and male rheumatologists received significantly higher payments than female rheumatologists.