One-quarter got general payments of 'significant financial interest.'
This article first appeared on Monday, August 5, 2019 in MedPage Today.
By Ian Ingram, Deputy Managing Editor, MedPage Today.
Roughly half of physician directors (49%) for National Cancer Institute (NCI)-designated cancer centers received general or research payments from industry in 2017, a new study found.
And among the 53 physicians holding these top positions, 23% received over $5,000 in general payments, which is defined by the NCI as being of "significant financial interest," reported David Carr, MD, of the University of California San Diego, and H. Gilbert Welch, MD, MPH, formerly of the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire.
Industry payments that year totalled $4.42 million and consisted of $2.53 million for general payments (consulting, lectures, travel, other) and $1.89 million for research payments, they wrote in JAMA Internal Medicine.
"We were actually pleasantly surprised to find that only about half of directors received payments," Carr told MedPage Today. "This is a lower percentage than has been reported in some of the other cohorts that have been studied."
Past research on payments to authors of National Comprehensive Cancer Network guidelines, for example, found that about 84% received general payments and 47% received payments for research.
"These are the most prestigious cancer centers that exist in the whole country," said Carr. "I think that's a really promising finding."
The authors were particularly interested in the group receiving payments of over $5,000. Twelve of the 53 directors received general payments (23%) while 19 received payments for research (36%) that exceeded this amount. Overall, the median value of industry payments was higher for research versus general payments ($37,036 vs $5,828).
Two directors had general payments greater than $50,000 in 2017. Though not named in the article, these were:
- $2.27 million to Laurie Glimcher, MD, of Dana-Farber/Harvard Cancer Center in Boston, the bulk of which came from Bristol-Myers Squibb (BMS) as "compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program"; in 2018, Glimcher again received over $2 million in general payments, again largely from BMS.
- $65,514 to Richard Fisher, MD, of Fox Chase Cancer Center in Philadelphia, mostly from consulting fees from Genentech, Bayer, and Sandoz; in 2018, Fisher received $16,513 from AstraZeneca and Bayer.
Last year, the New York Times and ProPublica investigation into José Baselga, MD, PhD, then the Chief Medical Officer of Memorial Sloan Kettering Cancer Center, shined a spotlight on industry involvement and conflicts of interest among top physicians at cancer centers. (The fallout from the investigation ultimately led to Baselga's resignation.)
Carr said the news broke while he and Welch were conducting the exploratory data collection for their study and it spurred them on to continue. "It seemed to be a pretty important issue," he said.
Some experts have argued that any type of industry payment can be problematic, but the NCI's conflict of interest policy is "silent" on the research funding, they noted. In the study, four directors received general payments greater than $50,000 in 2017.
To conduct their research, the authors used Open Payments to examine industry payments from 2015 to 2017 to the 53 physician directors at the 70 NCI-designated cancer centers. All medical device and pharmaceutical companies are required by law to report research and general payments made to U.S. physicians to the database, which is run by the Centers for Medicare & Medicaid Services. As such, any payments to the 16 non-physician directors were not available.
Among the 53 physician NCI cancer center directors in 2017, general payments were made to 22 while research payments were made to 12 (some received both). No payments for that year were listed in Open Payments as being under dispute.
Carr and Welch disclosed no relevant relationships with industry.
“We were actually pleasantly surprised to find that only about half of directors received payments.”
David Carr, MD, University of California San Diego
KEY TAKEAWAYS
Among the 53 physicians holding these top positions, 23% received over $5,000 in general payments, which is defined as being of 'significant financial interest.'
Overall, the median value of industry payments was higher for research versus general payments ($37,036 vs $5,828).