Novartis and Bristol-Myers-Squibb Give Millions to Oregon Hospitals, Doctors
Which physicians and teaching hospitals in Oregon received the most money from drug and device manufacturers in 2013?
For the very first time, the Centers for Medicare and Medicaid Services is making such data public to increase transparency and accountability in our healthcare system. There’s only one shortcoming -- acknowledged by CMS – only data between August and December of 2013 has been made available. Yet, those 4.4 million payments nationwide accounted for nearly $3.5 billion, which were given to 546,000 physicians and nearly 1,360 teaching hospitals. The complete report for 2013 should be available by June 2015. This $3.5 billion includes money paid out as consulting fees, research grants, gifts, travel payments and is divided into three categories:
- General payments;
- Research payments; and
- Physician ownership and investments (Modern Healthcare, 9/30).
In addition, the data include physicians' ownership stakes in "group purchasing organizations," which buy drugs and devices for broader populations.
In Oregon, meanwhile, its physicians and teaching hospitals were paid $9.65 million from 348 manufacturers or group purchasing organizations. It’s no huge surprise that Oregon Health & Science University walked away as the largest benefactor -- $5.4 million, followed by Providence Health & Science University, which had a much smaller slice -- $382,146 – Legacy Emanuel Medical Center with $175,755 - - Kaiser Foundation hospitals took in $28,055 – St. Charles Health System -- $17,941 – Good Samaritan Hospital in Corvallis -- $17,981 -- Sky Lakes Medical Center, $1,633 and Legacy Good Samaritan, $1,400.
Also, the average research payment to OHSU was $76,500. Providence Health & Services, the hospital with the second highest research payments, averaged just over $33,000.
Physician Payments at Teaching Hospitals
The largest amount of money came from two separate contributions from Novartis Pharmaceuticals, which totaled $1,941,319 followed by $1,053,167 from Bristol-Myers Squibb and $454,355 from Pfizer. All told, 348 companies are listed in the Excel spreadsheet produced by The Lund Report.
At OHSU, most of its dollars went toward physicians doing research on cancer – also there is no disclosure in this CMS report about which pharmaceutical companies and device manufacturers gave out these specific amounts. Beyond this list, there was also $809,259 given to a researcher at OHSU but no primary investigator was named. In all, 65 physicians at OHSU received $5,049,489 from 121 pharmaceutical companies and device manufacturers.
The largest amounts came from:
- Novartis Pharmaceuticals, $1,793,757;
- Bristol-Myers-Squibb, $1,015,468;
- Incyte Corporation, $429,154;
- Pfizer, $353,362;
- Janssen Research and Development, $318,868; and
- ARIAD Pharmaceuticals at $304,234.
Who were the top researchers at OHSU receiving those payments:
- Dr. Rodney Pommier, a surgical oncologist received the highest amount, $1,064,015;
- Dr. Julie Graff, who investigates prostate cancer, was given $1,003,851;
- Dr. Michael Heinnrich focuses on new cancer treatments and received $838,798;013;
- Dr. Kimn-Hien-Thi Dao, a hematologist, was paid $428,854; and
- Dr. Jeffrey Alan Payne, director of the Layton Aging and Alzheimer’s disease Center, $88,775.
Providence Health & Services received $363,918 during 2013, while $200,000 went to a principal investigator whose name was not provided. Dr. Carlo Bruno Bifulco, who specializes in anatomic pathology and clinical pathology, received $38,066.
Legacy Emanuel Medical Center received $75,455 with the largest amount, $35,795 going to an unknown principal investigator, while Kaiser was paid $11,624; and Good Samaritan Medical Center, $1,889.
Individual Physicians Benefitted
Doctors throughout Oregon also benefitted from $3,854,941 for such projects as serving as faculty or as a speaker at a venue other than a continuing education program, which amounted to $928,960; travel and lodging, $516,415; food and beverage, $411,027; grants, $248,963; education, $199,154; royalties or licenses, $182,729; current or prospective ownership or investment interest, $120,565; honoraria, $86,593; gifts, $68,722; space or rental or facility fees at teaching hospitals, $43,237; charitable contributions, $10,894 and entertainment, $383.
Among the top 30 recipients of these funds were:
- Dr. Mark Jewell, a plastic surgeon in Eugene, $177,999;
- Dr. Jay Malmquist, an oral surgeon in Portland, $125,454;
- Dr. Glenn Keiper, a spinal surgeon in Eugene, $122,248
- Dr. Stanley Barnwell, neurological surgery in Portland, $91,967;
- Dr. Scott Kitchel, a spine surgeon from Eugene, $91,506;
- Dr. Matthew Riddle, who focuses on diabetes in Portland, $85,966;
- Dr. Brya Mehlhaff, an urologist from Springfield, $69,895;
- Dr. Michael McClung, whose work focuses on osteoporosis of Portland, $64,116;
- Dr. Robert Martindale, whose specialty is surgery and digestive health in Portland, $61,225; and
- Dr. Patrick Boyle, of Depoe Bay, an endocrinologist, who received $58,466 and was the highest recipient of funds from Good Samaritan Medical Center in Corvallis.
Inside the Open Payments Report
This data is part of the Open Payments program, created by a section of the Affordable Care Act called the Sunshine Act that was designed to shed some light on the huge amounts of money exchanged between pharmaceutical companies and healthcare providers — money that may affect doctors' decisions about their patients.
"Research has shown that physician–industry relationships do influence prescribing behavior," to Dr. Shantanu Agrawal, a deputy administrator at CMS and director of CMS’ Center for Program Integrity, said during a conference call with reporters in early October. "The data does not identify which financial relationships are beneficial, and which might represent conflicts of interest."
According to the press release issued by CMS, "This initial public posting of data is only the first phase of the Open Payments program," said CMS Administrator Marilyn Tavenner, M.A."In coming weeks, we will be adding additional data and tools that will give consumers, researchers and others a detailed look into this industry and its financial arrangements."
But, he added, that the presence of a physician's name on the site does not necessarily imply any wrongdoing.
"Open Payments does not identify which financial relationships are beneficial and which could cause conflicts of interest. It simply makes the data available to the public. So while these data could discourage payments and others transfers of value that might have an inappropriate influence on research, education and clinical decision-making, they could also help identify relationships that lead to the development of beneficial new technologies.
Marilyn Tavenner, administrator of CMS, said her agency is “committed to transparency, and this is an opportunity for the public to learn about the relationships among healthcare providers, and pharmaceutical and device companies. This initial public posting of data is only the first phase of the Open Payments program. In coming weeks, we will be adding additional data and tools that will give consumers, researchers, and others a detailed look into this industry and its financial arrangements.”
Manufacturers submitted data to CMS this summer, and CMS performed initial matching to aggregate payments to a single physician or teaching hospital. After the data were collected and displayed, registered physicians and teaching hospitals had the opportunity to review payments reported about them and dispute information they believed inaccurate, according to the press release.
More than 26,000 physicians and 400 teaching hospitals registered in the Open Payments system to review payments attributed to them. During the review and dispute period, CMS identified payment records that had inconsistent physician information, such as National Provider Identifier for one doctor and a license number for another. In cases where CMS was unable to match the physician information or the record was not available for review and dispute but the company had attested that the payment had been made, the personally-identifiable information has been suppressed temporarily in the record.
About 40 percent of the records published today are de-identified. This data will be fully identifiable in 2015 after the reporting entity submits corrected data, and physicians and teaching hospitals have a chance to review and dispute. In addition, data that were disputed and not resolved by the by the end of the September 11 review period have not been published and will be updated at a later date.
Over time, CMS expects to make enhancements such as introducing new tools to allow for easier data searches. This improved search functionality will allow users to more easily review payments received by their personal physician, or search on criteria such as specialty, location, or types of payments received.
Building on its commitment to transparency, the Open Payments program is the latest effort by CMS to make healthcare cost data available to the public. For example, the agency continues to publicly release and update data allowing consumers to compare what hospitals charge for common inpatient and outpatient services across the country.
To view the Open Payments physician payment dataset and other background, visit: http://www.cms.gov/openpayments/.