Industry Financial Relationships in Neurosurgery in 2015: Analysis of the Sunshine Act Open Payments Database

World Neurosurg. 2018 Jun:114:e920-e925. doi: 10.1016/j.wneu.2018.03.116. Epub 2018 Mar 23.


Objective: The 2013 Physician Payments Sunshine Act mandates that all U.S. drug and device manufacturers disclose payments to physicians. All payments are made available annually in the Open Payments Database (OPD). Our aim was to determine prevalence, magnitude, and nature of these payments to physicians performing neurologic surgery in 2015 and to discuss the role that financial conflicts of interest play in neurosurgery.

Methods: All records of industry financial relationships with physicians identified by the neurological surgery taxonomy code in 2015 were accessed via the OPD. Data were analyzed in terms of type and amounts of payments, companies making payments, and comparison with previous studies.

Results: In 2015, 83,690 payments (totaling $99,048,607) were made to 7613 physicians by 330 companies. Of these, 0.01% were >$1 million, and 73.2% were <$100. The mean payment ($13,010) was substantially greater than the median ($114). Royalties and licensing accounted for the largest monetary value of payments (74.2%) but only 1.7% of the total number. Food and beverage payments were the most commonly reported transaction (75%) but accounted for only 2.5% of total reported monetary value. Neurologic surgery had the second highest average total payment per physician of any specialty.

Conclusions: The neurological surgery specialty receives substantial annual payments from industry in the United States. The overall value is driven by a small number of payments of high monetary value. The OPD provides a unique opportunity for increased transparency in industry-physician relationships facilitating disclosure of financial conflicts of interest.

Keywords: Conflicts of interest; Ethics; Industry; Neurosurgery; Open Payments Database; Sunshine Act.

MeSH terms

  • Databases, Factual / economics
  • Databases, Factual / statistics & numerical data*
  • Disclosure / statistics & numerical data*
  • Drug Industry / economics
  • Drug Industry / statistics & numerical data*
  • Humans
  • Medicaid / economics
  • Medicaid / statistics & numerical data
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Neurosurgeons / economics
  • Neurosurgeons / statistics & numerical data*
  • Neurosurgery / economics
  • Neurosurgery / statistics & numerical data*
  • Patient Protection and Affordable Care Act / economics
  • Patient Protection and Affordable Care Act / statistics & numerical data
  • Physician Payment Review Commission / economics
  • Physician Payment Review Commission / statistics & numerical data
  • United States / epidemiology