Study evaluates industry payments to orthopedic surgeons

Issue: December 2011

An analysis of financial payments made by orthopedic device manufacturers to orthopedic surgeons between 2007 and 2010 has shown a reduction in total number of payments — and total amount of funds distributed — after payment disclosure was required, according to a report in the Oct. 24 issue of Archives of Internal Medicine.

The findings also reported an increase in the proportion of consultants with academic affiliations, according to an Archives of Internal Medicine news release.

“There is ongoing discussion of physician relationships with the pharmaceutical industry and medical device manufacturers,” lead author Jason M. Hockenberry, PhD, and his colleagues wrote. “Our objective was to use data made available by a U.S. Department of Justice lawsuit to describe the extent of orthopedic surgeons’ financial relationships with implant manufacturers.”

Study findings

According to the release, in 2005 the Department of Justice launched an investigation into payments made to orthopedic surgeons by the five largest makers of artificial hips and knees, reaching a settlement with these companies — Zimmer, DePuy Orthopaedics, Biomet, Smith & Nephew and Stryker — in 2007. Data made available by this settlement was used to examine the payments made by device manufacturers to orthopedic surgeons.

Factors the researchers examined included the number of surgeons receiving payments, the amount of money paid and the types of payments made from 2007 through 2010.

The study found that in 2007, the manufacturers made 1,041 payments to 939 orthopedic surgeons for a total of more than $198 million. The year following the settlement, 2008, saw manufacturers made 568 payments to 526 surgeons for a total of around $228 million — though the authors noted this figure included $109 million in royalty buyouts from Zimmer.

Clearer requirements needed

Three of the companies in the settlement reported data for all 4 years examined in the study. The authors found mean payments from these device makers totaled $212,740 per surgeon in 2007. This total dropped to $193,943 in 2008, then increased again to $246,867 in 2009 and $233,108 in 2010.

“Although mandating disclosure of consulting payments and efforts by academic institutions to ‘monitor their own’ seem prudent, universal and detailed disclosure with standardized reporting formats and data elements would make these data more useful to patients, providers and policymakers,” the authors concluded. “There is a need for clearer specific requirements for disclosure to allow for meaningful long-term analyses to be performed.”

The authors also found an increase in the proportion of surgeons with academic affiliations who received payments — from 39.4% in 2007 to 44.9% in 2008. According to the release, the authors observed similar patterns in 2009 and 2010 for the three companies that continued disclosing payments.

Reference:

Hockenberry JM, Weigel P, Auerbach A, Cram P. Financial payments by orthopedic device makers to orthopedic surgeons. Arch Intern Med. 2011. doi:10.1001/archinternmed.2011.454

www.pubs.ama-assn.org

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