Open payments: CMS reports docs, hospitals received $7.5B in 2015

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New open data from the Centers for Medicare & Medicaid Services reveals that physicians and teaching hospitals received $7.52 billion in payments from healthcare companies in 2015.

The federal government, under the Sunshine Act, must publish on a public website the financial interactions between manufacturers of drugs, devices, biologicals and medical supplies to individual physicians and teaching hospitals.

The 2015 payments included nearly $3.9 billion in research related payments, $2.6 billion in non-research-related payments and more than $1 billion representing ownership or investment interests held by physicians or their immediate family members, according to a CMS announcement.

Physicians specializing in nuclear medicine received the biggest payments, averaging $51,279, far higher than the $8,037 per physician reported in 2014. Neurological surgeons retained their second spot on the list, with an average payment of more than $26,104, only about $55 higher than in 2014.  Orthopedic surgeons, who averaged payments of more than $34,596 in 2014, saw their payments drop to third place on the list, to a little more than $26,000.

Nevertheless, the recipient of the biggest single payment on the entire list was North Kansas City orthopedic surgeon Roger P. Jackson, M.D. In January 2015 he received a $30 million royalty payment from NuVasive, Inc., a California company that specializes in medical devices for spinal care. Jackson has earned tens of millions of dollars over the years as the holder of patents for a variety of surgical instruments and devices, including a surgery table named after him that was specially designed for orthopedic patients. Jackson earned nearly $38.4 million in payments last year, more than triple the $11.9 million he received in 2014 and 10 times the $3.83 million he received in 2013.

The biggest single payment to a hospital was City of Hope National Medical Center, a cancer hospital in Duarte, California. It received a $22.3 million royalty payment from drug company Genentech. Altogether, it received $306.7 million in payments last year, of which just under $7.1 million were research-based payments. In 2014, it received $251.2 million in payments, of which $6.2 million were for research. In 2013, it received $122.7 million, of which $2.53 million was for research.

CMS said it publishes the open payment data to better promote transparency in healthcare delivery and finance.

“Transparency is empowering physicians to be purposeful about their financial relationships with companies, and there is a notable shift toward charitable contributions and away from other interactions such as honoraria and gifts,” said Shantanu Agrawal, M.D., a CMS deputy administrator and director of the agency's Center for Program Integrity, in a statement.

More than 2 percent of the total payments to doctors from drug companies that were tracked by CMS involved opioid painkillers. The issue is surrounded by controversy, particularly the growing crisis of addiction to prescription painkillers in the U.S. A recent poll conducted in part by the Harvard School of Public Health indicated more than a third of Americans blame the prescribing practices of doctors for the epidemic. The issue also prompted the U.S. Centers for Disease Control and Prevention to issue new guidelines to primary care physicians on how to prescribe such painkillers.

However, the American Medical Association questioned the quality of the data.

“While we appreciate the efforts of the CMS to verify the data submitted by industry, continued data errors and registration challenges during the previous two years have thwarted many physicians from participating in the review and validation process,” the AMA said in a statement. The integrity goals of the Open Payments database will not be met as long as physician review is obstructed by a registration procedure that is confusing, time consuming, and overly burdensome. Patients deserve to have access to accurate information. Publishing inaccurate data leads to misinterpretations, harms reputations and undermines the trust that patients have in their physicians. It can also discourage research and care delivery improvements that benefit patients.”

- here's the CMS announcement (.pdf)
- visit the CMS database
- check out the AMA statement