A look at physician payments for 2018 as reported by pharmaceutical companies to the Centers for Medicare & Medicaid Services (CMS) Open Payments Database

(January 13, 2019)

The "Open Payments Database" (OPD) is a disclosure program created in 2013 as part of the Affordable Care Act. The program promotes transparency and accountability by helping consumers understand the financial relationships between pharmaceutical/medical device industries and physicians/teaching hospitals. CMS notes that "financial ties between the health care industry and health care providers do not necessarily indicate an improper relationship."

Here's why OPD might be useful to you:

  1. search the database by physician name to find out if your doctor or surgeon received payments from a pharmaceutical or medical device company, and learn detail about the payment (e.g. if it was for meals, travel, speaking fee, gift, etc.). Many physicians receive the occasional meal delivered by pharmaceutical reps. For example, a physician or group at a practice might be giving up their lunch hour to listen to the rep's presentation. So one has to be careful about deciding which payments are concerning.
  2. If you are a patient at a teaching hospital, search by your hospital name to find out which pharmaceutical or medical device companies made payments to the hospital.

A notable industry trend is increased spending on physicians by biopharmaceutical companies like Genentech, Biogene, and Celgene. Some pharmaceutical companies, meanwhile, are upping their donations to patient advocacy groups. Critics say this is an alarming trend since large corporate donations to the charities might create conflicts of interest.

The table below lists examples of companies that spent tens of millions of dollars in 2017 on physicians as reported in the Open Payments Database. Research payments to physicians at teaching hospitals are not included in the totals. Note that California-based cancer drug maker Genentech (including both Genentech Inc. and Genentech USA) spent almost half a billion dollars on general physician payments in 2017. The amounts presented are for U.S. companies only. Links go to patient reviews or ratings forms for drugs.

Company Payments Example Drugs
GENENTECH INC./USA $438,614,265 Rituxan
ALLERGAN INC. $67,459,728 Botox, Restasis, Viberzi
ASTRAZENECA $49,145,363 Bydureon, Brilinta, Symbicort
PFIZER INC. $47,499,156 Eliquis, Xeljanz, Lyrica
BIOGEN $47,378,225 Avonex
VALEANT $43,597,728 Dermatop
JANSSEN $42,164,378 Xarelto, Invokana, Invega
MERCK $41,505,995 Keytruda, Belsomra, Januvia
ABBVIE $40,806,099 Humira, Viekira, Androgel
GENZYME $39,450,841 Taxotere
CELGENE $38,882,221 Otezla
GILEAD SCIENCES $37,524,087 Harvoni, Ranexa, Sovaldi
AMGEN $33,567,971 Neulasta, Prolia, Repatha

Sources and More Reading:
- Center for Medicare Services (CMS) Open Payments Database (OPD). Includes data since August 2013. Search by physician name, company name (including pharmaceutical and medical device companies), country of company, and teaching hospital. Results include number of payments, dollar amounts, drug or product associated with a payment, and nature of the payment. Includes data through the end of 2018.

- Facts about the Open Payments Data for 2019: https://openpaymentsdata.cms.gov/summary Includes summary information such as: 10.35 million separate general payments were made totaling $3.56 billion in 2019 ( $3.01 billion in 2018 and $2.82 billion in general payments in 2017). Also provides research payments amounts and disputed payment amounts.

- Additional data analysis is available from Propublica's Dollars for Docs Database (covers through December 2018).

- OPD in the news: "A potent and controversial new opioid painkiller won federal approval this month based heavily on the work of a University of Minnesota doctor with a history of paid advocacy for the pharmaceutical industry." November 19, 2018. Star Tribune: http://www.startribune.com/u-doctor-in-middle-of-opioid-conflict/500756911/

- Enacted about seven years ago, the Physician's Payment Sunshine Act requires that pharmaceutical and medical device companies disclose gifts to physicians. An investigation into the policy's impact so far reveals that the law has not changed physician, consumer, or patient behavior. The study's authors argue that disclosure is not enough to address industry relationships in medicine.

-"Pharmaceutical Companies' Payments for Physicians"- Infographic of physician payment table  used in this article

Payments to Doctors from Pharma from CMS Open Payments