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Erik Mothersbaugh, Elizabeth Wyles; Three Years of the Sunshine Act: An Analysis of Industry Payments to Eye Care Providers. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5226.
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© ARVO (1962-2015); The Authors (2016-present)
Financial relationships between physicians and companies within the medical industry, who desire to sell drugs and devices, can create conflicts of interest for doctors that potentially impact patient care. Studies consistently show that industry promotion influences prescribing behavior, despite doctors' belief that they are unaffected. Eye care providers take an oath to protect patients above personal gain, so increasing awareness and understanding of these financial relationships can improve patient care.The Physician Payments Sunshine Act of 2010 requires payments from industry to physicians to be reported. Payments are publicly available on the Centers for Medicare & Medicaid Services (CMS) Open Payments website. The website provides transparency of these relationships beyond that of previous policies. To the authors' knowledge, no data has been analyzed for eye care providers with comparisons between optometry and ophthalmology.
All General Payments in the CMS database to optometrists (ODs) and ophthalmologists (OMDs) from 2014 to 2016 are included in our retrospective data review. General Payments include cash or cash equivalent (e.g. consulting/speaking fees, honoraria) and in-kind items and services (e.g. food/beverage, travel). Payments for research and ownership/investment dividends are not included.
From 2014 to 2016, a total of $63.9M in payments were made to 40,837 ODs (Mean $1.5K, Range $1.25-$1.2M), and a total of $172.2M in payments were made to 21,784 OMDs (Mean $7.9K, Range $0.70-$12.4M). Payments were highly disproportional between providers, with $35.4M (55.4%) paid to 408 ODs (1%), and $116.5M (67.6%) paid to 218 OMDs (1%).
Voluntary financial relationships with industry are variable in eye care. Most providers (approximately 98%) accepted at least one transaction, but a majority of industry's financial investment went to a small minority of doctors in each profession. This may provide insight into the marketing strategies used by industry, such as the training and development of "thought leaders" who may have influence over other prescribers. Despite the majority of payments going to a select few, research in social psychology suggests that even small gifts influence behavior. Presentation of these data can increase awareness of potential conflicts of interest and may be used as a reference when developing policies to improve patient care.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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