title: Industry Relationships With Pediatricians: Findings From the Open Payments Sunshine Act.
abstract: Ties between physicians and pharmaceutical/medical device manufactures have received considerable attention. The Open Payments program, part of the Affordable Care Act, requires public reporting of payments to physicians from industry. We sought to describe payments from industry to physicians caring for children by (1) comparing payments to pediatricians to other medical specialties, (2) determining variation in payments among pediatric subspecialties, and (3) identifying the types of payment and the products associated with payments to pediatricians.
  
  
  
  We conducted a descriptive, cross-sectional analysis of Open Payments data from January 1 to December 31, 2014. The primary outcomes included percent of physicians receiving payments, median total pay per physician, the types of payments received, and the drugs and devices associated with payments.
  
  
  
  There were 9 638 825 payments to physicians, totaling $1 186 217 157. There were 244 915 payments to general pediatricians and pediatric subspecialists, totaling >$32 million. The median individual payment to general pediatricians was $14.63 (interquartile range 12-20), and median total pay per general pediatrician was $89 (interquartile range 32-186). General pediatricians accounted for 1.7% of total payments, and 0.9% of the sum of payments. Developmental pediatricians had the highest percentage of pediatric physicians receiving payment, and pediatric endocrinologists received the highest median payment. Top marketed medications were for attention-deficient/hyperactivity disorder and vaccinations.
  
  
  
  More than 40% of pediatricians received payments from industry in 2014, a lower percentage than family physicians or internists. There was considerable variation in physician-industry ties among the pediatric subspecialties. Most payments were associated with medications that treat attention-deficient/hyperactivity disorder and vaccinations.
authors.affiliation: Division of Hospitalist Medicine, Department of Pediatrics, Children's National Medical Center and George Washington School of Medicine, Washington, District of Columbia; kparikh@childrensnational.org.
authors.forename: Kavita
authors.initials: K
authors.lastname: Parikh
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine, New Haven, Connecticut; and Centers for Medicare and Medicaid Services, Department of Health and Human Services, Washington, District of Columbia.
authors.forename: William
authors.initials: W
authors.lastname: Fleischman
authors.affiliation: Centers for Medicare and Medicaid Services, Department of Health and Human Services, Washington, District of Columbia.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Agrawal
mesh_terms: D003430:Cross-Sectional Studies; D004345:Drug Industry / Q000191:economics*; D004864:Equipment and Supplies; D037921:Gift Giving; D007400:Interprofessional Relations; D066192:Manufacturing Industry / Q000191:economics*; D058991:Patient Protection and Affordable Care Act; D000072143:Pediatricians / Q000191:economics* / Q000941:ethics / Q000331:legislation & jurisprudence; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence; D014481:United States