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Industry Payments to Obstetricians and Gynecologists Under the Sunshine Act

Muffly, Tyler M., MD; Giamberardino, Whitney L., MD; Guido, Joseph, CHP; Weterings, Robbie, PhD; Bastow, Brittney, MD; Sheeder, Jeanelle, PhD

doi: 10.1097/AOG.0000000000002684
Contents: Original Research

OBJECTIVE: To evaluate financial relationships between obstetrician–gynecologists (ob-gyns) and industry, including the prevalence, magnitude, and the nature of payments.

METHODS: We conducted a cross-sectional study in which we obtained a list of industry contributions to U.S. obstetricians and gynecologists through the Centers for Medicare and Medicaid Services Open Payments Database from August 1, 2013, to December 31, 2015. These data were cross-referenced with the entire cohort of practicing obstetricians and gynecologists, who were identified using the National Provider Identification database, because not all practicing ob-gyns received payments. These payments were analyzed with respect to 1) types of payments, 2) demographic attributes of health care providers receiving payments, and 3) comparisons between obstetrician and gynecologist subspecialties. Continuous data were compared using the Mann-Whitney test for variables that were not normally distributed and with the t test for variables that are normally distributed.

RESULTS: A total of 517,077 nonresearch payments, totaling $79,965,244, were made to 23,292 ob-gyns. Physicians receiving payments were predominantly female, younger than 65 years old, allopathic physicians who graduated from U.S. medical schools in the late 1990s, and were board-certified subspecialists (P<.001 for all). Half of all ob-gyns received payments of varying amounts from drug manufacturers, device manufacturers, or both, with most of the payments for honoraria, faculty compensation, or consulting. Female pelvic medicine and reconstructive surgery physicians received the largest median dollar amount; maternal–fetal medicine physicians received the smallest.

CONCLUSION: Obstetricians and gynecologists receive a substantial amount of payments from industry. Most of these payments were for honoraria, faculty compensation, or consulting and totaled less than $400 per health care provider. Although this total amount is less than typically received by surgical providers, including orthopedic surgeons who account for the highest compensated group in total and mean industry payments, the median payment value for obstetrics and gynecology subspecialists surpasses the median payment to orthopedic surgeons. These financial relationships warrant further exploration with future research.

Half of practicing obstetrician–gynecologists received financial payments of some kind from a pharmaceutical or device maker or both, with the majority receiving less than $400.

Female Pelvic Medicine and Reconstructive Surgery, Denver Health and Hospital Authority, Denver, and the University of Colorado School of Medicine, Aurora, Colorado; MJW Technical Services, Amherst, New York; and Cat Drop Foundation, Drachten, The Netherlands.

Corresponding author: Tyler M. Muffly, MD, Denver Health and Hospital Authority, 777 Bannock Street, MC0660, Denver, CO 80204; email: tyler.muffly@dhha.org.

This project was conducted without financial support from reportable sources, and no funding was received from any of the following institutions: National Institutes of Health, Welcome Trust, or the Howard Hughes Medical Institute.

Presented at the American Urogynecologic Society PFD Week, October 3–7, 2017, Providence, Rhode Island.

Each author has indicated that he or she has met the journal's requirements for authorship.

Received January 2, 2018. Received in revised form March 8, 2018. Accepted March 23, 2018.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.