Nearly six in 10 doctors in the United States received more than $12 billion in payments from pharmaceutical companies over the past decade, an analysis has found.
A study by researchers at Yale University found that 57 percent of doctors earned huge sums of money from manufacturers related to drugs or medical devices between 2013 and 2022.
Most of the money went to consulting services or fees for things like acting as a speaker at a venue, but doctors also received large amounts of money for food, drinks and gifts.
Orthopedic surgeons were found to receive the largest total amount of payments, $1.36 billion, and the most common medications linked to the payments were blood thinners Xarelto and Eliquis.
One medical device that ranked among the industry’s top five payment-related medical devices was Impella, a device used in some types of cardiac surgery.
Some Impella devices were withdrawn in December by the FDA due to a risk of perforation that “can cause serious injury or death.”
“Despite evidence that financial conflicts of interest can influence physicians’ prescribing and damage patients’ trust in medical professionals, such payments remain ubiquitous,” the researchers wrote.
Orthopedic surgeons were found to have received the largest total amount of payments, $1.36 billion.
The drugs linked to the highest industry payments were the blood thinners rivaroxaban (brand name Xarelto) and apixaban (brand name Eliquis) used to prevent blood clots and strokes in people with atrial fibrillation.
The researchers used data from the Open Payments platform, a publicly accessible national database where drug and medical device companies disclose payments made to doctors.
Researchers included payments for consulting services, fees for acting as a speaker or faculty at a venue, food and beverages, travel and accommodations, entertainment, education, gifts, grants, and charitable contributions.
Between August 2013 and 2022, U.S. drug and device manufacturers made more than 85 million payments, totaling $12 billion, to 826,313 of the 1.4 million eligible doctors in the United States.
After orthopedic surgeons, the doctors who received the highest total payments were neurologists and psychiatrists, who received $1.32 billion, and cardiologists, who received $1.29 billion.
Although the median payment to doctors was $48, payments to the top 0.1 percent of doctors were much higher and differed by specialty.
The average amount paid to the top 0.1 percent of orthopedists was $4,826,944.
For the top 0.1 percent of cardiologists, it was $3,197,675, and for the top 0.1 percent of neurologists and psychiatrists it was $2,588,819.
The drugs linked to the highest industry payments were the blood thinners rivaroxaban (brand name Xarelto) and apixaban (brand name Eliquis) used to prevent blood clots and strokes in people with atrial fibrillation.
They were followed by adalimumab (Humira), to treat psoriasis, and canaglifozin (Invokana) and empagliflozin (Jardiance), both used to treat type 2 diabetes.
The industry’s top payment-related medical device was the da Vinci Surgical System, a robotic system that uses a minimally invasive surgical approach.
More than 60,000 surgeons worldwide are trained on da Vinci systems.
Next up was Mako SmartRobotics, which is used for minimally invasive knee and hip replacements.
This was followed by CoreValve Evolut, a transcatheter aortic valve replacement, Natrelle Implants, which are used for breast implants.
In fifth place was Impella, a support device used in some types of cardiac surgery.
The FDA recently issued a recall for some Impella devices, a BMJ report according to the study, due to perforation risks.