Pandemic Drove Drop in Industry Payments to Rheumatologists

Payments to rheumatologists from industry declined early in the COVID-19 pandemic but showed some rebound in 2021, based on information from the Open Payments Database (OPD).

The OPD was established in 2013 to improve transparency in financial relationships between industry and health care professionals in the United States, although many physicians and much of the general public is unaware of the OPD, Anju Murayama of the Medical Governance Research Institute, Tokyo, and colleagues wrote.

The COVID-19 pandemic may have limited rheumatologists’ involvement with industry, but potential changes in financial relationships during the pandemic have not been well studied, they wrote.

In a study published in the Journal of Rheumatology, the researchers reviewed data from 6,047 rheumatologists who received at least one general payment from industry between August 2013 and December 2021. The total value of the payments was $288,326,257.

The data set included all general payments made to the physicians whose primary specialty was categorized as rheumatology in the National Plan and Provider Enumeration System profile. The payment information came from the OPD and included payments between August 2013 and December 2021.

In this analysis, the periods before and after March 2020 were considered as before and after the pandemic, respectively.

At the onset of the pandemic, monthly payments to rheumatologists overall decreased by 65.1%, and the number of rheumatologists who received payments decreased by 39.8%; a decrease occurred across all levels of payment.

“However, the recovery trend in payments during the pandemic was higher among the rheumatologists with lower payments,” the researchers noted.

The most significant decreases across payment types occurred in travel and accommodation, which dropped by 98.2% at the start of the pandemic. Payments for speaking engagements and meals decreased by 72.3% and 72.0%, respectively, at the start of the pandemic; consulting payments decreased by 23.3%.

The number of rheumatologists with payments ranged from 3,547 in 2020 to 4,444 in 2015, and did not change significantly between 2014 and 2019. However, the median total payments increased from $730 in 2014 to $812 in 2019.

Compared with the 2014-2019 period, the number of rheumatologists with payments in 2020-2021 decreased by 21.7% and the payments per rheumatologist decreased by 41.9% (P < .001 for both).

In 2021, general payments to rheumatologists were still below levels from the 2014-2019 period.

The study findings were limited by the exclusion of rheumatologist without payments and the lack of data on confounding factors, the researchers noted. However, the study is the first to show the impact of the COVID-19 pandemic on the financial relationships between U.S. rheumatologists and industry.

“Although there were recovering trends in general payments right after the onset of the COVID-19 pandemic, we observed general payments remaining at low levels between 2020 and 2021,” they noted.

A previous study showed that general payments to rheumatologists between 2013 and 2015 were significantly associated with increased prescription of brand-name rheumatology drugs and health care use. But more long-term studies are needed “to investigate whether this downward trend in general payments [observed in the current study] has contributed to reducing undue influence on rheumatologists’ clinical practice,” the researchers concluded.

The study received no outside funding. One coauthor disclosed personal fees from Medical Network Systems unrelated to the current study. The study authors had no financial conflicts related to the current study, but continue to research financial and nonfinancial conflicts of interest among health care professionals and pharmaceutical companies in Japan and the United States.

This article originally appeared on, part of the Medscape Professional Network.

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