Shedding Light: Trends in Industry-Sponsored Research in Plastic Surgery Since the Sunshine Act
Sumun Khetpal1, Nicole Le, MD, MPH2, Maham Ahmad, BA1, Jeegan Parikh, MBBS, MPH2, Neil Pathak, MD, MPH1, Navid Pourtaheri, MD, PhD1, Michael Alperovich, MD, MSc1.
1Yale University, New Haven, CT, USA, 2University of South Florida, Tampa, FL, USA.
BackgroundFinancial contributions from industry for physician-led research has been historically challenging to study in plastic surgery. However, as mandated by the Physician Payments Sunshine Act of 2013, the Open Payments Database (OPD) has increased transparency in payments from industry to physicians. This study aimed to analyze trends in industry-sponsored research funding for plastic surgeons.
MethodsUsing the OPD, research payments from industry made to plastic surgeons from 2014 to 2018 were examined. Total payments and number of payments were recorded by recipient’s census region (e.g., Northeast, Midwest, South, West) and therapeutic area (e.g., breast prosthetics/reconstruction, wound healing/tissue engineering, software/instrumentation, biologics, cosmetics/injectables). Payments totaled across five years in each therapeutic area for each region were also analyzed. Location of company U.S. headquarters and therapeutic area were recorded. Statistical analyses were performed using SAS 9.4. Brown-Mood test, t-test, Kruskall-Wallis, Mann Whitney, and linear regression tests were utilized.
ResultsFrom 2014 to 2018, a total of 3,271 research payments were made to 403 physicians, amounting to $7,465,770. However, total payment volume and number of payments in each therapeutic area significantly decreased from 2014 ($2,381,745, N=728) to 2018 ($709,643, N=267). The majority of payment volume was allocated to private practice surgeons (98%), as opposed to academic surgeons (2%). Aggregated across all five years, the South had the highest payment volume (36%). Breast prosthetics/reconstruction had the highest number of payments (n=2,661), followed by cosmetics/injectables (n=235), wound healing/tissue engineering (n=186), biologics (n=133), and software/instrumentation (n=56). Wound healing/tissue engineering had the highest total payment ($2,187,653), followed by breast prosthetics/reconstruction ($1,732,400), cosmetics/injectables ($1,280,999), biologics ($475,093), and software/instrumentation ($163,173). The median payment amount increased for biologic (p=0.0324), from $2,572 in 2014 to $3,470 in 2018 (p<0.0001). On the other hand, the median payment amount significantly decreased for cosmetics/injectables (p<0.0001). The majority of payment volume in cosmetics/injectables (71%) was allocated to the South. The majority of payment volume in software/instrumentation (50%) and biologics (60%) was allocated to the West.
ConclusionOver five years, the greatest payment volume was allocated to wound healing/tissue engineering, while the number of payments was highest in breast prosthetics/reconstruction. We found that certain therapeutic areas had a greater presence in particular regions; this could be a reflection of patient demand as opposed to company headquarter location. Private plastic surgeons receive significantly higher payments compared to academic plastic surgeons. Greater transparency and additional years of OPD data may provide further insight into industry influence on physician-led research in plastic surgery.
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