Nationwide Patterns in Industry Payments to Academic Vascular Surgeons

J Vasc Surg. 2020 Jun 11;S0741-5214(20)31319-7. doi: 10.1016/j.jvs.2020.04.527. Online ahead of print.

Abstract

Objective: Financial relationships between vascular surgeons (VS) and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly available financial transactions between industry and academic VS.

Methods: Academic VS were identified and characterized based on publicly available data correlated with Accreditation Council for Graduate Medical Education (ACGME) and Association of American Medical Colleges (AAMC) data to identify academic practice settings. VS were linked to Open Payments data for 2017 as reported by the Centers for Medicare and Medicaid Services (CMS). Univariate and nonparametric tests were used for analysis.

Results: Of 1,158 academic VS identified, 997 (86%) received industry payments totaling $8,548,034. Overall, the median of total payments received was $814 [IQR $124 - $2,863]. The top paid decile of VS received $29,645 [IQR $16,128 - $61,701]. Payments to the top decile accounted for 81% of all payments. Payments did not vary by academic rank but did vary by gender with male VS (n=954) receiving $889 [IQR $146 - $3,217] vs female VS (n=204) receiving $467 [IQR $87 - $1,533] (P=0.002). By leadership role, division chiefs received the highest median payment amount ($1,571 [IQR $368 - $11,281]) compared to department chairs ($424 [IQR $56 - $2,698]) and VS without leadership role ($769 [IQR $117 - $2,592]) (P=0.002). Differences in payments were also seen based on US census region: Northeast $571 [IQR $90 - $2,462], Midwest $590 [$75 - $2,364], South $1085 [IQR $241 - $3,405], and West $1044 [IQR $161 - $4,887] (P=0.001). The most common categories of payments were Food and Beverage (paid to 85% of all VS), Travel and Lodging (35%) and Consulting Fees (13%). Among the top decile of VS, median payments exceeded $10,000 for 3 categories: Consulting Fees, Compensation, and Honoraria. Payments were made by 178 distinct entities with median total payments of $286 [IQR $70 - $6,285]. The 3 top entities paid a total of $5,004,061 which accounted for 59% of all payments. Payments from at least one of the top 3 entities reached 76% of VS.

Conclusion: Most academic VS receive publicly reported industry payments which are paid by a limited number of entities, typically for food and beverage or travel and lodging. The top 10% of VS received higher median payment amounts, totaling 81% of all industry payments. VS should be aware of publicly reported payment information and the potential for conflicts of interest.

Keywords: Academic Surgery; Industry Relationships; Open Payments; Vascular Surgery.