Nearly six in 10 U.S. physicians have received more than $12 billion in payments from pharmaceutical companies over the past decade, an analysis shows.
A study by researchers at Yale University found that 57 percent of physicians earned huge amounts of money from manufacturers in connection with medical drugs or devices between 2013 and 2022.
Most of the money went to consultancy services or fees for, for example, speaking at a venue, but the doctors also received large sums of money for food and drinks and gifts.
Orthopedic surgeons were found to receive the largest total amount of payments, at $1.36 billion, and the most common medications associated with payments were the blood thinners Xarelto and Eliquis.
One medical device found in the top five medical devices by industry payments was Impella, a device used in some types of heart surgery.
Some Impella devices were recalled by the FDA in December due to a puncture risk that “could cause serious injury or death.”
“Despite evidence that financial conflicts of interest can influence physicians’ prescribing and damage patients’ trust in medical professionals, such payments remain pervasive,” the researchers wrote.
Orthopedic surgeons were found to receive the largest total amount of payments, at $1.36 billion
The drugs associated with the highest industry payments were the blood thinners rivaroxaban (brand name Xarelto) and apixaban (brand name Eliquis) used to prevent blood clots and strokes in people with atrial fibrillation.
The researchers used data from the Open Payments platform, a publicly accessible national database where drug and medical device companies disclose payments to doctors.
The researchers include payments for consulting services, honoraria for serving as a speaker or faculty at a venue, food and beverages, travel and lodging, entertainment, education, gifts, grants and charitable contributions.
Between August 2013 and 2022, U.S. drug and device manufacturers made more than 85 million payments, totaling $12 billion, to 826,313 of the 1.4 million eligible physicians in the U.S.
After orthopedic surgeons, the physicians who received the largest total amounts of payments were neurologists and psychiatrists, who received $1.32 billion, and cardiologists, who received $1.29 billion.
Although the average payment to physicians was $48, payments to the top 0.1 percent of physicians were much higher and varied depending on specialty.
The average amount paid to the top 0.1 percent of orthopedists was $4,826,944.
For the top 0.1 percent of cardiologists it was $3,197,675, and for the top 0.1 percent of neurologists and psychiatrists it was $2,588,819.
The drugs associated with the highest industry payments were the blood thinners rivaroxaban (brand name Xarelto) and apixaban (brand name Eliquis) used to prevent blood clots and strokes in people with atrial fibrillation.
They were followed by adalimumab (Humira), for treating psoriasis, and canaglifozin (Invokana) and empagliflozin (Jardiance), both used to treat type 2 diabetes.
The most significant medical device associated with industry payments was the da Vinci surgical system – a robotic system that uses a minimally invasive surgical approach.
More than 60,000 surgeons worldwide have been trained in da Vinci systems.
The next step was Mako SmartRobotics, which is used for minimally invasive knee and hip replacements.
This was followed by CoreValve Evolut, a transcatheter to replace an aortic valve, Natrelle Implants, which is used for breast implants.
In fifth place was Impella, a support device used in some types of heart surgery.
The FDA recently issued a recall for some Impella devices BMJ report emphasized on the study, due to perforation risks.