Cross-sectional analysis of Open payments for physicians at designated hemophilia centers in the US (2018-2020)

Abstract

Introduction: Physicians who treat hemophilia, and especially directors at hemophilia centers, are in a position to be unduly influenced by payments from pharmaceutical companies who make costly hemophilia drugs. It is from this perspective that we analyzed payments made to physicians at hemophilia centers in the US, focusing on center directors. Materials and methods: In a cross-sectional analysis we searched the CDCs Hemophilia Treatment Center Directory for physicians (2022) and then abstracted general payments for physicians on Open Payments (2018-2020) and calculated one-year average payments. We searched academic websites to determine physician role (hemophilia center director, non-director, or non-center director). Results: There were 420 physicians in the hemophilia physician directory: 270 physicians/professors, 103 directors of hemophilia centers, and 47 other directors. Directors of hemophilia centers had higher median one-year general payments, compared to other directors and physician/professors ($4910 vs $79 vs $87, respectively; p<0.0001). Takeda Pharmaceutical Company Limited, F-Hoffmann La Roche Ltd/Genentech, and Novo Nordisk have the largest hemophilia drug market share and were the three companies with the most payments to physicians. Conclusions: High payments, especially among individuals who have responsibility over the success of hemophilia centers and clinics, may result in competition with the interest of the patients at these centers and clinics.

Competing Interest Statement

Vinay Prasads Disclosures. (Research funding) Arnold Ventures (Royalties) Johns Hopkins Press, Medscape (Honoraria) Grand Rounds/lectures from universities, medical centers, non-profits, professional societies, Youtube, and Substack. (Consulting) UnitedHealthcare. (Speaking fees) Evicore. (Other) Plenary Session podcast has Patreon backers. All other authors have no financial nor non-financial conflicts of interest to report.

Funding Statement

This study was funded by Arnold Ventures

Author Declarations

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Data Availability

All data produced are available online at CMS Open Payments (https://openpaymentsdata.cms.gov/) and Centers for Disease Control and Prevention (CDC) Hemophilia Treatment Center Directory (https://dbdgateway.cdc.gov/HTCDirSearch.aspx)

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