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A retrospective review of data released to the public by the Centers for Medicare & Medicaid Services (CMS), covering Aug. 1 through Dec. 31, 2013, found that most individual payments by industry to ophthalmologists are fairly small, with the largest dollar amounts going to relatively few recipients.1
During those five months, drug companies, device makers, and other entities made nearly 56,000 individual payments, totaling almost $11 million, to 9,855 ophthalmologists. These payments covered everything from meals to consulting arrangements, speakers’ fees, and royalties.
Payment practices. Some key findings on payments to ophthalmologists are as follows:
- More than 86 percent of individual payments were for food and beverage, though this represented only 15 percent of total spending.
- Nearly three-fourths of payments were $50 or less.
- The greatest percentage of total spending went to consulting fees.
- Payments to ophthalmologists were in line with payments in other subspecialties, including dermatology, orthopedic surgery, urology, and neurosurgery.
What does it mean? The expenditure reports, mandated by the 2010 Physician Payments Sunshine Act, are intended to bring transparency to the relationship between physicians and industry. “It seems difficult to know what the significance is of seeing a physician’s name associated with these payments,” said Jonathan S. Chang, MD, who reviewed the data. “But studies have shown that industry spending can influence physician decision making despite the fact that physicians themselves do not believe that they are greatly influenced.”
Going forward, it would help to see the data in the context of prescribing and practice patterns, which are reported separately by CMS, said Dr. Chang, who is assistant professor of ophthalmology at Columbia University.
For now, he said, “We need to be aware of what is being reported about ourselves and each other because, despite limitations in the data, policymakers will use this information to affect future decision making, practice patterns, and reimbursements.”
—Miriam Karmel
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1 Chang JS. Ophthalmology. 2015;122(4):656-661.
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Dr. Chang reports no related financial interests.
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