Infectious Disease

Industry payment distributions may be skewed by 0.1% of physician earners

Evan Vega March 30, 2024

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March 28, 2024

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Key takeaways:

Industry payment totals may be skewed by 0.1% of physicians who received more than $1 million from 2013 to 2022.
Orthopedists, neurologists, psychiatrists and cardiologists received the highest total payments.

According to published results, industry payment distributions may be skewed by the 0.1% of physicians in each specialty who were paid more than $1 million from 2013 to 2022.

Ahmed Sayed, MBBS, and colleagues used data from the open payments platform to analyze industry payments to physicians of various specialties from August 2013 to December 2022. Researchers also analyzed the top 25 drugs and top 25 medical devices related to the most industry payments during the same period.

Money and Stethoscope

Industry payment totals may be skewed by the 0.1% of physician earners. Image: Adobe Stock

According to the study, 85,087,744 industry payments were made to 826,313 physicians for a total value of $12.13 billion between August 2013 and December 2022. Researchers found 93.8% of these payments were associated with at least one marketed medical product.

Total industry payments were highest in 2019 ($1.6 billion) and lowest in 2020 ($863.93 million). The number of physicians receiving payments was highest in 2015 (468,164 physicians) and lowest in 2020 (359,509 physicians). Researchers also found the total value of payments decreased from $1.34 billion in 2014 to $1.28 billion in 2022.

When reviewing distributions by specialty, researchers found:

Orthopedic physicians (n = 48,665) received the highest total industry payments ($1.36 billion), with $1,187 paid to the median physician and $4,826,944 paid to the top 0.1% of physicians.
Neurologists and psychiatrists (n = 107,684) received $1.32 billion in total industry payments, with $32 paid to the median physician and $2,588,819 paid to the top 0.1% of physicians.
Cardiologists (n = 46,171) received $1.29 billion in total industry payments, with $1,764 paid to the median physician and $3,187,675 paid to the top 0.1% of physicians.
Pediatric surgeons (n = 1,537) received the lowest total industry payments ($2.89 million), with $74 paid to the median physician and $338,183 paid to the top 0.1% of physicians.

Researchers noted payment distributions were skewed, with payments to the median physician ranging from $0 to $2,339 and payments to the top 0.1% of physicians ranging from $194,933 for hospitalists to $4,826,944 for orthopedic physicians.

According to the study, the three drugs associated with the most industry payments were Xarelto (rivaroxaban, Janssen; $176.34 million), Eliquis (apixaban, Bristol Myers Squib; $102.62 million) and Humira (adalimumab, AbbVie; $100.17 million).

The three medical devices associated with the most payments were the da Vinci Surgical System (Intuitive Surgical; $307.52 million), Mako SmartRobotics (Stryker; $50.13 million) and CoreValve Evolut (Medtronic; $44.79 million).

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