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Cross-sectional analysis of open payments for physicians at designated hemophilia centers in the US (2018-2020)
1Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA 94158, United States of America.
Insights
Physicians directing hemophilia centers receive significantly higher payments from pharmaceutical companies than other physicians. This financial influence may conflict with patient interests in hemophilia treatment.
Area of Science:
- Hematology
- Medical Ethics
- Pharmaceutical Industry Analysis
Background:
- Physicians treating hemophilia, particularly center directors, may be influenced by pharmaceutical payments.
- The financial relationship between drug companies and physicians is a critical area of concern in specialized medical fields.
Purpose of the Study:
- To analyze payments made to physicians at hemophilia centers in the US.
- To specifically investigate potential undue influence on hemophilia center directors due to pharmaceutical company funding.
Main Methods:
- Cross-sectional analysis of the CDC's Hemophilia Treatment Center Directory (2022).
- Abstraction of general payments data from Open Payments (2018-2020) for physicians.
- Categorization of physician roles (center director, non-director, other director) via academic websites.
Main Results:
- Hemophilia center directors received substantially higher median one-year payments ($4910) compared to other directors ($79) and physicians/professors ($87).
- Takeda, Roche/Genentech, and Novo Nordisk were the top pharmaceutical companies paying physicians in this field.
- Statistical significance (p < 0.0001) confirmed the disparity in payments.
Conclusions:
- Elevated payments to hemophilia center directors raise concerns about potential conflicts of interest.
- Financial incentives may compromise the primary interests of patients receiving care at hemophilia centers.
Introduction:
Physicians who treat hemophilia, and especially directors at hemophilia centers, are in a position to be unduly influenced by payments from pharmaceutical companies who make costly hemophilia drugs. It is from this perspective that we analyzed payments made to physicians at hemophilia centers in the US, focusing on center directors.
Materials And Methods:
In a cross-sectional analysis we searched the CDC's Hemophilia Treatment Center Directory for physicians (2022) and then abstracted general payments for physicians on Open Payments (2018-2020) and calculated one-year average payments. We searched academic websites to determine physician role (hemophilia center director, non-director, or non-center director).
Results:
There were 420 physicians in the hemophilia physician directory - 270 physicians/professors, 103 directors of hemophilia centers, and 47 other directors. Directors of hemophilia centers had higher median one-year general payments, compared to other directors and physician/professors ($4910 vs $79 vs $87, respectively; p < 0.0001). Takeda Pharmaceutical Company Limited, F-Hoffmann La Roche Ltd./Genentech, and Novo Nordisk have the largest hemophilia drug market share and were the three companies with the most payments to physicians.
Conclusions:
High payments, especially among individuals who have responsibility over the success of hemophilia centers and clinics, may result in competition with the interest of the patients at these centers and clinics.
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