By Andrew M. Seaman
(Reuters Health) - Nearly three-quarters of U.S. dermatologists received payments worth a collective $34 million from drug companies in 2014, according to a new analysis of a public database.
In most cases, the payments were worth less than $50, researchers found. But a few doctors were taking industry payments worth at least $93,622.
“Most dermatologist in the U.S. – about 73 percent according to this database – received some form of payment from industry,” said lead author Dr. Marie Leger, a dermatologist at Weill Cornell Medicine and NewYork-Presbyterian in New York City. “That being said, most dermatologists get a modest amount from industry.”
It’s difficult to know what these payments mean, but seeing how money flows from industry to the dermatology profession is important to understanding the relationship between those two groups, Leger told Reuters Health.
She and her colleagues analyzed data from the Centers for Medicare and Medicaid Services Sunshine Act Open Payment database, which records payments made to doctors from U.S. medical manufacturers and group-purchasing organizations.
They found that in 2014, 8,333 dermatologists received 208,613 different payments totaling about $34 million. Those payments could take a number of forms, including gifts, grants, education, consulting and food and beverages.
That $34 million, however, represents less than 1 percent of the roughly $6.5 billion paid to doctors in 2014, the researchers report in JAMA Dermatology.
A quarter of dermatologists received less than $100, 63 percent received less than $500 and 78 percent received less than $1,000. The top 10 percent of doctors received at least $3,940, which represented 90 percent of the total paid to dermatologists.
“I think we knew there were interactions, but we didn’t know how many interactions there were,” said lead author Dr. Hao Feng, of NYU Langone Medical Center in New York City. “We were surprised that in general it was a modest amount of money.”
The top 1 percent of dermatologists received at least $93,622, which accounted for 44 percent of the total.
About 81 percent of the compensation to the dermatologists came from drug companies.
Almost a third of payments were listed as speaking fees, about 22 percent were listed as consulting fees and about 17 percent were listed as research payments.
Dr. Jack Resneck, of the University of California, San Francisco School of Medicine, points out in an accompanying editorial that the payment database is limited.
He wrote that it can be improved if providers are allowed to see what payments industry submit and by the categories better describing interactions.
“Some straightforward changes would substantially improve the situation,” he wrote.
Since the database is missing information about the context of these payments, it’s difficult to get a better understanding of the interaction between industry and doctors, Feng told Reuters Health.
“That’s something that is really difficult – if not impossible - to get from this database,” said Feng.
For example, Leger wondered if the financial connection between industry and dermatology may affect how the specialty advocates for patients in terms of drug costs.
“I think this study maps points of contact in an important way and I think there’s more to explore for what those points of contact mean,” she said.