A cross-sectional analysis of open payments from pharmaceutical companies to memory center physicians

The development of anti-amyloid monoclonal antibodies has changed the landscape of care for patients with Alzheimer's disease (AD). The potential for financial conflicts of interest (COIs) for physicians related to these medications is unknown.

A cross-sectional analysis of open payments from industry to physicians working in memory clinics was conducted. The US News Best Hospitals for Neurology and Neurosurgery was used to identify the top 50 ranked hospitals. For each hospital, a google search was performed to identify any affiliated memory clinic. A list of physicians practicing in the memory clinic was identified from public websites. Physician specialty (neurology, geriatrics, psychiatry, or other) was abstracted. The Center for Medicare & Medicaid Services Open Payments database was used to search for general industry payments to each physician for the years 2020-2023. Mean and median yearly payments and number of payments were calculated. Payments from all pharmaceutical companies as well as the pharmaceutical companies responsible for lecanemab (Biogen and Eisai) and donanemab (Eli Lilly and Company/Lilly USA) were abstracted.

Thirty-one memory clinics with 244 total physicians were identified; 173 were neurologists, 37 psychiatrists, 30 geriatricians, and 4 other specialists. Mean one-year payment was $1562 (SD 4021) for neurologists, $974 (SD 5153) for geriatricians, and $460 (SD 1932) for psychiatrists. Forty neurologists (40/173, 23%) received mean yearly payments of ≥$1000, compared with one geriatrician (1/30, 3.3%) and two psychiatrists (2/37, 5.4%). Payments from Biogen, Eisai, and Eli Lilly and Company/Lilly USA comprised 51% of general payments.

Most physicians working in a sample of memory clinics received no or low amounts of general payments. Neurologists were more likely to receive general payments from industry. Payments from Biogen, Eisai, and Eli Lilly and Company/Lilly USA were substantial. Future work should evaluate the relationship between industry payments and anti-amyloid prescribing patterns.