Main Session
Sep
27
PQA 02 - Pediatric Cancer, Sarcoma and Cutaneous Tumors, Medical Education & Professional Development, and Health Services Research
2385 - Temporal Trends and Concentration of General vs. Research Industry Payments in Radiation Oncology
Presenter(s)
Vedant Tiwari, - University of California, Irvine, Orange, CA
V. Tiwari, J. Jang, K. S. Hanubal, N. V. Peterson, M. E. Daly, and J. P. Harris; Department of Radiation Oncology, University of California - Irvine, Orange, CA
Purpose/Objective(s):
As federal research funding becomes more competitive and less predictable, alternative sources of support may play a larger role in academic careers. Recent NIH FY2025 data showed sharp declines in R01-equivalent funding rates across career stages, underscoring a strained funding environment. We investigated national temporal trends in general and research payments to radiation oncologists to characterize the distribution and potential stability of nonfederal funding sources.Materials/Methods:
CMS Open Payments data from 2020-2024 were analyzed for radiation oncologists. General and research payments were analyzed separately. Annual physician participation, total value, median payments, Gini coefficients, and the share of the top 50 in payments were calculated; payment category breakdowns and PI participation were assessed. Trends were assessed by linear regression across the five study years (p-trend).Results:
General payment participation increased from 2,157 (2020) to 3,291 (2024) (p-trend=0.011). Total annual payment value rose from $4.47M in 2020, peaked at $6.53M in 2022, and remained elevated in 2024 at $6.03M (p-trend=0.177). Median general payment per physician rose by more than double ($76.91-$158.35; p-trend=0.013). General payments became less concentrated (Gini: 0.93 in 2020 to 0.89 in 2024; p-trend=0.013). The share of yearly payments to the top 50 physicians (~1.5% of recipients) declined from 69.7% in 2020 to 55.9% in 2024 (p-trend=0.015). While meals dominated payment counts (85.1-90.5%), consulting and speaking comprised most general payment value (58.6-71.3%). Research payment value peaked at $49.58M in 2022, and declined to $41.54M in 2024 (-16%; p-trend=0.255). PI participation rose from 259 in 2020, peaking at 310 in 2023 before declining to 289 in 2024 (p-trend=0.337). Median research payment per PI was $29,109 (2020), peaked at $38,335 (2022), and was $30,000 (2024) (p-trend=0.661). Research payments were concentrated (Gini: 0.74-0.76), and the top 50 PIs (17-19% of PIs) received 73.9-78.5% of funding. General payments were more concentrated than research payments. Yearly Gini differences (general - research) ranged from 0.131-0.185; bootstrap 95% CIs excluded 0 in all years (CIs: 0.081-0.142 to 0.183-0.231). Overlap between the top 50 general payment recipients and research PIs was limited (12-14%).Conclusion:
Industry payments in radiation oncology are highly concentrated and bifurcated: a small group captures most general compensation, while a distinct group captures most industry-supported research funding. While general payments have expanded over time in terms of physicians paid, both general and research payments peaked in total value in 2022 and have since declined. These findings suggest industry support is unevenly distributed and may influence research sustainability amid funding uncertainty.