Trends in Industry Payments to Plastic Surgeons - What does the Sunshine Act Database Tell Us?
Rizwan Ahmed, MD1, Joseph Lopez, MD, MBA2, Scott Bloom, MD1, Dorry Segev, Md PhD2, Evan Westrick, MD1, Joshua Spiegel, MD1, James May, MD3, Scott Lifchez, MD4.
1Florida Hospital, Orlando, FL, USA, 2Johns Hopkins University, Baltimore, MD, USA, 3Harvard University, Boston, MA, USA, 4Johns Hopkins Hospital, Baltimore, MD, USA.
PURPOSE: The purpose of this study was to identify and characterize financial transactions between biomedical companies and plastic surgeons since the implementation of the Sunshine Act.
METHODS: We analyzed payment trends using Physician Payment Sunshine Act (PPSA) data (January 2014-December 2017) to assess industry payments made to plastic surgeons over four years published in the Open Payments Program website.
RESULTS: In 2014, $26,709,248 was paid to 5,316 plastic surgeons; the median (IQR) was $255 (101-660) and mean (SD) was $5,024 (± 133,531). In 2015, $19,653,379 was paid to 5,366 plastic surgeons; the median (IQR) was $298 (110-861) and mean (SD) was $3,662 (± 67,915). In 2016, $21,544,043 was paid to 5,308 plastic surgeons; the median (IQR) was $286 (107- 894) and mean (SD) was $4,058 (± 68,607). In 2017, $23,066,378 was paid to 5,384 plastic surgeons; the median (IQR) was $238 (88-726) and mean (SD) was $4,284 (± 93,185). The highest payments by payment category were made for royalties and licensing fees: $13,806,934 in 2014 to 20 plastic surgeons; $6,974,734 in 2015 to 20 plastic surgeons; $7,224,323 in 2016 to 22 plastic surgeons; and $9,168,129 in 2017 to 24 plastic surgeons. The second highest payment category was speaker fees: $4,976,016 in 2014 to 253 plastic surgeons; $4,425,901 in 2015 to 295 plastic surgeons; $3,956,768 in 2016 to 246 plastic surgeons; and $5,110,970 in 2017 to 201 plastic surgeons. The third highest payment category was consulting fees: $2,932,708 in 2014 to 292 plastic surgeons; $2,746,140 in 2015 to 293 plastic surgeons; $3,500,132 in 2016 to 332 plastic surgeons; and $3,891,218 in 2017 to 461 plastic surgeons. For four consecutive years Allergan was the highest paying company (Fig 1).
CONCLUSION: While the PPSA has been implemented to provide transparency to patients regarding industry's' payments to physicians, its implementation was fraught with speculation that payment trends would change. The 2014-2017 PPSA data demonstrate that there have been minimal changes in payments trends to plastic surgeons over the past four fiscal years.
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