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Original Investigation
July 3, 2019

Characteristics of Industry Payments to Ophthalmologists in the Open Payments Database

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, Ann Arbor, Michigan
JAMA Ophthalmol. 2019;137(9):1038-1044. doi:10.1001/jamaophthalmol.2019.2456
Key Points

Question  What are the characteristics of the reported industry payments made to ophthalmologists in the Open Payments Database?

Findings  In this analysis, the Open Payments Database reported a total of 20 943 ophthalmologists receiving 736 517 payments worth more than half a billion dollars (median payment per ophthalmologist, $637.75) during a 5-year period (2013-2017). Distribution was skewed, with few ophthalmologists receiving the most funding.

Meaning  Although the veracity of the industry payment reports cannot be confirmed, the findings suggest that ophthalmologists' receipt of industry payments are extensive, which could be associated with possible conflicts of interest and biased clinical practices.

Abstract

Importance  An increased awareness of the interactions between the medical industry and health care professionals may lead to lower health care costs and more effective health care practices.

Objective  To assess the characteristics of industry payments made to ophthalmologists between 2013 and 2017.

Design, Setting, and Participants  This analysis included data reported in the June 29, 2018, update of the Centers for Medicare & Medicaid Services Open Payments Database (OPD). The OPD contains public records of industry payments made to physicians and teaching hospitals from August 1, 2013, to December 31, 2017, as reported by the medical industry. All general or research payments distributed to US ophthalmologists and contained in the OPD were included in this study. Data are summarized by practitioner, manufacturer, payment category, and geographic location.

Main Outcomes and Measures  Main outcomes were the distribution, quantity, and value of payments made to ophthalmologists practicing in the United States or US territories. The financial characteristics of payment category, manufacturer, product, and location were also assessed.

Results  This analysis revealed that the OPD showed industry reporting a total of 20 943 ophthalmologists receiving 736 517 payments worth $543 679 603.53 (1.67% of all industry-reported funds in the OPD). The median payment value was $22.44. Most payments were for food and beverages (581 588 [78.96%]), whereas most funds were allocated toward research ($310 142 151.88 [57.05%]) and consulting fees ($73 565 327.71 [13.51%]). The median payout to each ophthalmologist was $637.75 (interquartile range, $167.33-$2065.54). California was the highest-grossing state, receiving $101 135 980.34 (18.60%) of all payments. Fifteen companies were responsible for 87.68% of all funds distributed ($476 719 470.11) and were mostly involved in the production of pharmaceutical agents (anti–vascular endothelial growth factor agents, glaucoma eyedrops, and ocular lubricants) and surgical devices (cataract and glaucoma).

Conclusions and Relevance  Although there is no way to know the veracity of these reports, the findings suggest the financial ophthalmologist-industry relationship is substantial. These relationships may be adding to health care costs and affecting the quality of care, although those associations were not evaluated in this study.

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