Almost all teaching hospitals got industry payments, indicating there may be a need for better conflict of interest rules, according a study published Wednesday in the journal Health Affairs.
Researchers from Harvard Medical School and the University of Pittsburgh found 91% of teaching hospitals got some type of non-research payments. They were using data available under the Physician Payments Sunshine Act, which requires both teaching hospitals and physicians to post such payments. In total, the payments made by biomedical companies to teaching hospitals totaled $832 million in 2018.
“We observed substantial royalty payments, which may reflect the downstream benefits of research partnerships, as well as substantial payments for gifts and education, which raise concerns for institutional conflicts of interest,” researchers wrote in the study.
Researchers grouped the non-research industry payments into five categories: royalties and ownership, education-related payments, compensation for services such as consulting or speaking, gifts like meals or travel and charitable contributions.
A total of 529 companies made at least one payment to a teaching hospital in 2018. Nearly half of the companies were medical device or supplier manufacturers, 25% were drug manufacturers and 27% made a mix of product types.
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The payments were largely concentrated at one-fifth of all teaching hospitals, which received 90% of the payments.
The bulk of payments—$626 million—made by companies to hospitals were for royalties to hospitals for sales of products made by their intellectual property. That was followed by $102 million in payments for education, $23 million in the form of gifts and $74 million for service compensation such as consulting.
“Among payments related to products, the majority of royalty payments were related to biologics, whereas the majority of education-related payments and gifts were related to medical devices,” the authors of the study wrote.
The authors said that the payments are likely an underestimate of the “overall financial relationships between hospitals and industry.”
It added that financial payments from the industry to teaching hospitals are common and previously under-recognized.
“Hospitals should strengthen policies to prevent the institutional conflicts of interest that may arise from these payments while promoting beneficial industry collaborations,” the authors of the study said.
They also called for the Centers for Medicare & Medicaid Services to require all hospitals, not just teaching hospitals, to report industry payments. Of the 11,295 hospitals in the U.S. that participate in Medicare, nearly 1,300 of them are teaching hospitals.