BMJ 2015;351:h3697 doi: 10.1136/bmj.h3697 (Published 7 July 2015)

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NEWS Industry paid $6.5bn to US physicians and hospitals in 2014 Michael McCarthy Seattle

Drug and medical device makers paid $6.49bn (£4.2bn; €5.9bn) to physicians and teaching hospitals in the United States last year, reported the US Centers for Medicare and Medicaid Services.1

recipient. As a result, a principal investigator on a clinical trial might be reported as having received millions of dollars that year, but in reality the payment was being spent on research.

The Open Payments program, which was created by the 2010 Affordable Care Act, requires drug and device manufacturers to report all “transfers of value” to healthcare providers and teaching hospitals. These range from research grants to honorariums, speaking fees, travel expenses and meals, and payments in the form of stock, royalties, and other financial instruments.

In a statement the American Medical Association said that it was “committed to transparency” but criticized the government for providing physicians with only a 45 day window to review and correct any incorrect data and for setting up a registration process that, the association said, was “time-consuming, non-user friendly and complicated.”

The transactions were detailed in an open access database, called Open Payments, that provides information on more than 11.4 million financial transactions reported for the year between the industry and more than 600 000 physicians and 1100 teaching hospitals.

The database is searchable, so consumers can look up the financial relations that individual doctors and hospitals have with specific drug and medical device companies. The database was launched last year but covered payments only for half of 2013. This is the first time that the database has detailed payments for a full year. A similar searchable database providing details of payments from drug companies in the United Kingdom to doctors and teaching hospitals is expected to go online next year.2 Drug companies made payments totaling roughly £40m to 21 000 clinicians in the UK in 2012 and £38.5m in 2013.3

The updated US database shows that 1444 companies in the US reported $6.49bn in payments in 2014. About half, $3.23bn, went to payments for research, $2.56bn went to what are known as “general” payments, such as honorariums, fees to speakers, travel, gifts and entertainment, and $703m went to payments relating to investments or ownership. Of the $3.23bn in payments for research, $2.52bn went to individual physicians. This total, however, included payments in which an individual was named and payments for research projects in which the principal investigator was named as the

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However, individual physicians did receive $2.02bn in general payments and all of the $703m in payments relating to ownership or investment interest. Teaching hospitals received $705m in payments for research and $543m in general payments. No payments to hospitals for investments and ownership were reported.

The association said that being reported as receiving payment from the industry could “wrongly imply” that a physician has done something improper. It said, “The AMA strongly opposes inappropriate, unethical interactions between physicians and industry. However, some relationships with industry can help drive innovation in patient care, contribute to the economic well-being of communities, and provide significant resources for professional medical education, to the ultimate benefit of patients.”

The Centers for Medicare and Medicaid Services said that during the review period doctors and hospitals logged on and reviewed nearly 30% of the total value of payments reported for 2014, but it said that it would continue to work with physicians and hospitals to increase their review rate. 1 2 3

US Centers for Medicare & Medicaid Services. Open Payments. Jun 2015. www.cms. gov/OpenPayments. Coombes R. New year brings new transparency for drug company payments to doctors in UK. BMJ 2015;350:g7748. Dyer C. Who is paying your doctor? BMJ 2014;349:g4601.

Cite this as: BMJ 2015;351:h3697 © BMJ Publishing Group Ltd 2015

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Industry paid $6.5 bn to US physicians and hospitals in 2014.

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