To compare payments to neurologists from the pharmaceutical/device industry from 2015 to 2018 using the Centers for Medicare and Medicaid Services (CMS) Open Payments Database (OPD).

CMS publicly reports financial relationships between physicians and industry relationships in the OPD. We have published data on the 2015 payments. Here, we trend research, non-research and ownership payments from 2015 to 2018.

Retrospective cross-sectional analysis of payments using the 2015- 2018 OPD. We used the American Association of Medical Colleges State Physician Workforce Snapshots for the corresponding years to obtain the total number of practicing U.S. neurologists. We used chi-square test for proportions and t-test for continuous data.

Ninety-six percent of neurologists received non-research payments in 2015 vs. 91% in 2016 (Relative Risk, RR 0.94, 95% Confidence Interval, CI 0.88 -1). Total payments were: 2015: $93,930,993 (mean ± SD: $7,264 ± 8100) vs. 2016: $82,994,690 ($6,789 ± 827, mean decrease in 2016: $465, CI $335-$615).Per-physician payment ranges were: 2015: $0.03 to $1,322,146, median $407, IQR $1503; 2016: $0.03 to $1,681,428, median $357, IQR $1700. Food and beverage continued to be the most frequent category (2015: 83%, 2016: 84%, RR 1, CI 0.9-1.1). The highest amount paid in both years was for serving as faculty/speaker for non-continuing medical education activities (49% vs. 47% in 2015 vs.2016, RR 0.96, 0.72-1.28). The top sponsors were Teva Pharmaceuticals (2015, $16,461,055; 17.5%) and Genzyme Corporation (2016, $14,507,022; 17.5%). 

Despite CMS tracking and reporting industry payments, the proportion of paid neurologists, total payment amounts and categories of highest and most frequent non-research payments did not change substantially between 2015-2016. The top pharmaceutical sponsors were different but the amounts sponsored were roughly equal. The effect of the OPD program on neurologist payments needs further evaluation. Trends in all payment categories for the 2015-2018 periods will be presented.