Main Session
Sep
28
PQA 03 - Digital Health Innovation and Informatics, Patient Safety & Quality, and Radiation and Cancer Biology
Presenter(s)
Allison Randolph, MD, MBA - Johns Hopkins Medicine, Baltimore, MD
A. Randolph V1, Z. Hammadeh2, E. Lee2, M. Han3, and D. Song4; 1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, 2Johns Hopkins University, SOM, Baltimore, MD, 3Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, 4Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
Purpose/Objective(s):
Our study aims to assess relationships and trends in industry-sponsored research payments (ISRP) to radiation oncologists with specific accounting for non-covered entities (NCEs). We hypothesize that the relative funding allocation to NCEs is increasing when compared to covered entities. Further understanding these relationships and trends can help inform decision-making and illuminate shifts in research funding mechanisms.Materials/Methods:
We collected ISRP data from the Centers of Medicare and Medicaid Services (CMS)-published Open Payments Program (OPP) between 2015 and 2023. Each payment was inflation-adjusted and associated with a trial or research project and its associated radiation oncology principal investigator. Analysis included direct payments to either ‘covered entities’, consisting of physicians, Non-Physician Practitioners [NPPs] or teaching hospitals not employed by the industry payor, or ‘non-covered entities’ [NCEs], defined as third-party organizations that do not receive graduate medical education [GME] funding, such as independent research institutes and non-teaching hospitals. Payments were stratified by recipient status, associated product, associated manufacturer, primary principal investigator (PI) recipient identification/specialty, and date of payment. Outcome metrics were dollar amount of ISRPs paid and number of ISRP payments reported in totals, medians and maximums. Statistical analysis included generalized linear model (GLM) and generalized estimating equation (GEE) model regression utilizing R (R Core Team, version 4.4.2).Results:
ISRPs to radiation oncologists between 2015-2023 totaled $308M, significantly increasing annually over the study period from $16.7M to $48.1M (188%, p<0.01). ISRPs to covered recipients accounted for $82M (27% of total), increasing annually over the study period from $2.5M to $4.3M (72%, p=0.59). ISRPs to NCEs accounted for $226M (73% of total), increasing annually over the study period from $14.1M to $43.7M (209%, p=0.06). The overall trend of ISRPs for both covered entities and NCEs was positive; however, the rate increase was significantly higher among NCEs. The estimated rate of ISRP increase to NCEs over the study period was $23,621/month (SE: $7,562, p <0.01) compared to covered entities: $1,469/month (SE: $5,439, p = 0.79) (Figure 1). The top products associated with ISRPs to radiation oncologists were pembrolizumab ($80.3M, Merck), durvalumab ($31.8M, AstraZeneca), everolimus ($16.1M, Novartis), canakinumab ($9.3M, Novartis), and Lu-177 ($8.8M, Novartis).Conclusion:
Overall ISRPs to radiation oncologists increased between 2015-2023 with increasing allocation to NCEs. Most payments were associated with a small number of products and manufacturers. Understanding industry payment trends and practices is critical as a supplement and alternative to federal funding, particularly given uncertainty in future federal research support.