On August 1, 2013 the Physician Payment Sunshine Act went into effect. This law requires physicians and teaching hospitals, who receive payments or other “transfers of value” from drug and medical device manufacturers, to report those payments to the Centers for Medicare & Medicaid Services (CMS). The CMS collects the information and makes it publicly available (1) every June 30 for the previous year.
In this blog we take a look at the 2019 numbers in context, discuss how this treasure trove of Open Payments Data (OPD) can be used by medical affairs professionals to identify and prioritize external experts and explain how Monocl Professional simplifies this process by providing payment data in the context of comprehensive expert profiles.
A peek at the Open Payments Data
The CMS records payments in three different categories:
- Research payments – payments associated with a research study
- General payments – broad category of payments that are not associated with a research study, e.g. consulting or speaker fees, educational materials or meals and travel
- Value of ownership - ownership or investment interest a physician has in a company
OPD also provides an overview of payments made by companies.
A quick analysis shows the following trends (data from 2014 - 2019, excluding 2013 when only five months’ worth of data were collected).
- While the total value of payments has increased by approx. 20% the total number of records decreased by about 10% which lead to an increase in the average payment by about one third.
- The overwhelming majority (94.4%) of payments by number fall into the “General” category, but only 32% of total value is associated with “General”. Research payments account for 5% of payments but 48% of value. Only 0.02% of payments are associated with ownership interest but this small fraction accounts for 11% of total value.
- Ownership interest shows the largest average increase over the reporting period: while total payments increased only by about 10%, the number of recipients dropped by more than 50%. As a consequence, average ownership interest more than doubled between 2014 and 2019 from $210K to $486K.
- The number of physicians receiving payments decreased slightly (2%) over the reporting period and average general payments per physician is slightly up.
- Research payments overwhelmingly go to teaching hospitals. With the number of hospitals receiving payments slightly up but the overall payments increasing by over 40%, the average research payment per hospital increased by 35% between 2014 and 2019.
- The number of companies making payment has dipped for the first time in 2019, with 1602 companies it is now below the starting level of 1644 in 2014 and down approx. 5% form 2018 (1691).
In summary, over the reporting period the total payments made by the life science industry to external experts and hospitals has increased while the number of recipients has slightly decreased resulting in larger average payments with ownership interest showing the most dramatic increase.
While it is interesting to calculate averages and compare them over the life of the Sunshine Act, average numbers are not very informative for medical affairs professionals, who are looking to understand industry payments to experts whom they are engaged with or consider as future external experts.
Five main Open Payments Data use cases
Knowing how much and what type of payments a healthcare provider receives can inform the expert selection process. Our research at Monocl and discussions with our customers revealed five main use cases:
- Identifying experts with a history of industry payments – this establishes their affinity for industry collaborations, e.g. general payments for consulting indicate an expert’s interest in advising companies about medical products or treatments. Research payments show an interest in collaborative research work.
- Identifying the most frequently engaged experts in a therapeutic field – this indicates a clear willingness to partner with industry. This insight can serve two purposes: payments are often used as a proxy for impact the expert may generate scientifically. It can also serve as criterion for exclusion of an expert, e.g. those with established competitive relationships, or emerging experts rather than top established thought leaders.
- Gaining insights related to spend volume for promotional education activities for a particular drug class or field of therapy.
- Highlighting experts that have recent funding from direct competitors, specifically over time. An expert who has an ongoing relationship with a competitor may present challenges for deep engagement. However, a single industry payment from a competitor a few years back might indicate industry experience and be a positive rather than a negative criterion.
- Performing competitive intelligence by identifying expert relationships you share across companies, finding experts who have yet to be engaged, and following how relationships change over the course of an expert’s career.
Payment data, especially trends over time, are therefore a valuable source of information for medical affairs professionals when identifying, prioritizing and engaging external experts.
Industry Payments in Monocl Professional
Detailed information about each healthcare provider, who has received payments, is available in the OPD database and accessible as a standalone data stream. However, to create comprehensive expert profiles that data has to be integrated with other relevant information about the expert which, when done manually, is tedious and time-consuming.
To make this task easier for medical affairs professionals, Monocl Professional contains all Open Payments data including the most current release of 2019 data – all $10.3 billion in payments in 10.98 million of published records.
This allows a user to see all payments made to a specific expert over the entire reporting period in the context of all other activities of this expert. Intuitive visualization tools make it easy to discern trends, establish which company paid the expert how much, when and for what purpose and to compare different experts.
Monocl Professional is an expert-centric database with every search returning a list of experts that are relevant to the specific search term. Our in-house experts suggest to start a search with a relevant term, e.g. a disease, technique of interest or similar and then narrow down that list using filters including criteria such as industry payments.
In this example, we’ll start with the search term “breast cancer”, which returns over 339,000 experts worldwide. To narrow down that list we can apply a second filter, in this case we are focusing on experts who have been invited speakers at conferences. This decreases the number of hits to about 1750. Adding a requirement that an expert received $10K or more in general payments from life science companies results in a short list of 260 experts. Using Monocl Professional’s visualization tools make it easy to quickly identify the most relevant experts.
In each individual expert’s profile industry payments can then be analyzed by type and amount and explored in further detail.
Detailed records like the (anonymized) one shown in Fig 4 contain relevant information about a payment. For example, this expert recently received compensation for a speaking (or faculty) engagement from a company for a drug used to treat breast cancer.
Further, Monocl Professional shows that the expert does not have a history of receiving compensation from that company but received significant payments from a top 5 pharmaceutical company between 2016 and 2018. While the expert continues to receive general and research payments from this company, the level of involvement decreased significantly in the second part of 2019, perhaps indicating the availability of this expert for engagement.
Industry payments provide valuable information about scientific and medical experts and can lead to actionable insights, especially when considered in the context of an expert’s 360-degree profile as provided by Monocl Professional.
If you are interested in learning more about accessing that critical information through Monocl Professional, please contact us.