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Dan Gong, Jonathan S Chang; Difference-in-Differences Analysis of the Association between Publicly Reporting Physician-Industry Relationships and Industry Payments to Ophthalmologists. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6171.
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© ARVO (1962-2015); The Authors (2016-present)
The implementation of the Physician Payments Sunshine Act (PPSA) increased physician-industry relationship transparency, but the effect of this policy on the nature of physician-industry relationships in ophthalmology has not been characterized. Our study calculated the association between publicly reporting physician-industry relationships and industry payments to ophthalmologists.
This retrospective, longitudinal study reviewed physician-level Open Payments database payment records from August-December 2013-2015 for U.S. ophthalmologists. A difference-in-differences analysis compared changes in industry payments to ophthalmologists in years 1 and 2 of the PPSA implementation in five states and the District of Columbia with pre-existing industry payment disclosure laws to changes in thirteen contiguous states newly required to publicly disclose physician-industry relationships. A subsequent analysis was performed for years 2 and 3 of the PPSA implementation. State- and physician-fixed effects were included to control for time-invariant state- and physician-level characteristics.
Among the studied states, 4,634 ophthalmologists had $4.69 million payments in 2013 and $5.98 million payments in 2014. Mean number of payments per physician among states with pre-existing physician payment disclosure laws was 3.35 in 2013 and 3.31 in 2014; among newly affected states, the mean number of payments per physicians was 5.26 in 2013 and 4.96 in 2014. Implementation of the PPSA was associated with a 0.40 reduction in the number of payment records per physician (p=0.016, 95% CI [-0.73, -0.08]) in states without pre-existing physician payment disclosure laws compared to the states and D.C. with pre-existing disclosure laws. No significant association existed for payment amounts (β=-$10.68, p=0.97, 95% CI [-$616.35, $595.00]). Subsequent analysis of 2014 to 2015 data did not show a significant association for either the number or amount of industry payments to ophthalmologists.
Implementation of the PPSA was associated with a reduction in the mean number of industry payments per ophthalmologist during the first two years of the law’s enactment in states newly required to publicly disclose physician-industry relationships relative to states with pre-existing industry payment disclosure laws.
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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