1 in 4 Massachusetts Physicians Accepted Gifts From Pharma, Device Industry

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One in four Massachusetts physicians received payment or a gift worth $50 or more from pharmaceutical or medical device companies in the past two and a half years, according to an analysis of state records by the New England Journal of Medicine.

Massachusetts has required the reporting of such gifts valued at $50 or more into a state database since 2009. The gifts are linked to a physician's name, address and license number and categorized as compensation for bona fide services such as consulting or speaking engagements; food; grants; continuing medical education programs or conferences; education and training; marketing studies; charitable donations; or "other." CMS will phase in a federal version of the so-called "Sunshine Law" beginning Aug. 1.

Most of the gifts were meals or CME programs of the type that have been linked by research to physicians engaging in non-evidence-based prescribing practices, according to the NEJM's analysis of more than 32,000 reported payments worth $76.7 million to 11,734 physicians over 30 months of filings. Food payments were most common with 14,251 payments ranging from $69 to $164 in value for a total of $2.4 million over the two and a half years studied. Compensation for bona fide services was the highest-value category, with median payments ranging from $1,000 to $6,560 to total $67.3 million, accounting for 88 percent of total expenditures.

The amount spent and the number of physicians accepting gifts seems to have dropped each year, although average total payment per physician per year increased from $4,367 in 2010 to $4,944 in 2011, the most recent year of data analyzed.

The number of physicians accepting gifts — not including samples — from industry is declining in frequency, dropping from 83 percent of physicians in 2004 to 71 percent in 2009. Specialists have been far more likely to accept gifts than primary care physicians: Psychiatrists and internists ranked among the least likely to accept gifts, whereas cardiologists, urologists, gastroenterologists, rheumatologists and anesthesiologists are among the most likely. Orthopedic surgeons had the highest average per-physician payment total at $18,446 over the 30 months, or about $7,378 annually.

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