Trends in Nonresearch Industry Payments to Emergency Physicians Between 2016 and 2023

To characterize the prevalence, value, and nature of nonresearch industry payments made to emergency physicians in the United States between 2016 and 2023.

This was a repeated cross-sectional analysis of Open Payments data, which is annually released by the Centers for Medicare and Medicaid Services, from 2016 to 2023. We examined nonresearch industry payments to emergency physicians. The primary outcome was the annual proportion of emergency physicians receiving industry payments. The secondary outcomes were the total value of payments, payment regularity, and the distribution of payments by form, nature, and associated drug product. We used descriptive statistics to summarize trends.

A total of 27,970/80,270 (35%) emergency physicians received industry payments at least once during the study period of 2016-2023. The proportion of emergency physicians receiving payments decreased from 10,410/67,070 (16%) in 2016 to 8,770/79,600 (11%) in 2023, with an absolute difference between the 2 years of 4.5% (95% confidence interval: 4.2%, -4.9%). The total payment value decreased by 45% from $9.820 million in 2016 to $5.373 million in 2020 and then subsequently increased by 87% to $10.074 million in 2023. Only 0.8% of emergency physicians received payments every year they were eligible. Consulting fees became the highest-value payment in 2023, making up 50% of all payment value.

The proportion of emergency physicians receiving payments has decreased since 2016, whereas the overall value of payments has remained stable due to increasing concentration among a small group of recipients. These findings suggest evolving influence of industry and raise important questions about the influence of high-value relationships on clinical practice.