Dive Brief:

• An analysis of the 100 physicians receiving the highest compensation from 10 large surgical and medical device manufacturers in CMS’ 2015 Open Payments Database found a large discrepancy between the payment information reported and self-declared conflicts of interest.

• The analysis, published online in the Journal of the American Medical Association (JAMA) Surgery, found conflicts of interest were declared by those physicians in only 84 of 225 (37.3%) relevant published articles. A search of PubMed identified articles published by each physician from Jan. 1 through Dec. 31, 2016.
   
• The study published by doctors affiliated with the University of California, Irvine, proposed a policy for full disclosure in all publications.

Dive Insight:

The financial ties between doctors and pharmaceutical and medical device companies have been under scrutiny for years, prompting legislative and private actions to boost sunlight. Such compensation can be appropriate, the JAMA authors point out, but the risk for bias and undue influence must be guarded against.

Indeed, many universities and other groups require reporting compensation for consulting and other fees.

The JAMA study sampled 10 large surgical and medical device companies: Medtronic, Stryker, Intuitive Surgical, Covidien, Edwards Lifesciences, Ethicon, Olympus, W. L. Gore & Associates, LifeCell and Baxter Healthcare. Those companies made 570,524 payments, valued at more than $326.8 million, to 139,087 physicians in 2015, the study found.

Among the big companies, Medtronic was the most generous to doctors, making up more than $187.4 million of the total, followed by Stryker and Intuitive Surgical.

The report then identified the 10 physicians receiving the highest compensation from the 10 companies. The 100 most highly compensated physicians were paid more than $12.4 million in total, with a median payment of $95,993. Among the 100 highest-paid physicians, Stryker had the largest contribution at $2.5 million, followed by Intuitive Surgical and LifeCell.

The International Committee of Medical Journal Editors requires all authors to disclose potential conflicts of interest before an article submission. In 2010, the federal Sunshine Act mandated reporting of any payments to physicians from medical device, pharmaceutical and technology companies. CMS established the Open Payments Database in 2013 to house the information and increase transparency.

“A single standardized disclosure process used for all scholarly activities, implementation of a (conflict-of-interest) statement in article abstracts, and full disclosure of all financial ties, whether relevant or not, would eliminate any inconsistencies in disclosures and could help us move (one) step closer to full transparency,” the JAMA study said.