(320) Trends in Industry Payments to U.S. Oncologists: Insights from the 2014 –2023 CMS Open Payments Datasets

Background: : Prior research using the CMS Open Payments data found that from 2014 to 2018, annual number of payments and total value increased for oncology drugs , with oncologists (medical, hematology, radiation, and surgical) receiving 92% of all cancer drug payments in 2018. In oncology, where the drug market has experienced substantial growth and where treatments often carry high costs, it is critical to understand the landscape of industry payments to inform potential strategies for physician contracting and to guide the development of transparency-related performance measures.

Objective: : This study represents the initial phase of a broader analysis aimed at understanding financial conflict of interest and oncologist prescribing patterns. In this analysis, we focus on the CMS Open Payments data to characterize payments received by U.S. oncologists.

Methods: : We identified physicians specializing in oncology from the 2014 to 2023 CMS Open Payments datasets. To capture all payments made to oncologists, we took a broad approach, excluding only ownership or investment interest and acquisition payments, and did not limit to only transactions associated with cancer drugs. We conducted descriptive statistics to compare payments (adjusted in 2023 dollars) by program year, form of payment, and reporting entities.

Results: : Total payments to oncologists increased to approximately $123 million in 2023, reflecting an annual average increase of 4.5% since 2014. While total payments grew, median and average payment amount remained relatively steady, reaching $22.0 (0.9% annual increase) and $295.1 (1.3%) in 2023, respectively. In 2023, 10.5% of oncologists (n =1931) received >$10,000 in annual payments and 1.2% (n = 228) received >$100,000. Total payments to oncologists had the largest increase from 2014 to 2019, followed by a sharp decline in 2020, likely reflecting impacts of the COVID-19 pandemic, and then payments began to rise again from 2021 to 2023.

Conclusions: : This initial analysis highlights substantial and growing financial interactions between the pharmaceutical industry and oncologists over the past decade. Ongoing work will incorporate claims data to better understand how these financial relationships may relate to prescribing behaviors and inform managed care strategies.

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