Financial Conflicts of Interest Common Among Clinical Pathway Vendors

A majority of practitioners involved in clinical pathway development at three major oncology vendors received nonresearch general payments in 2015, according to research presented at the 2017 ASCO Annual Meeting.

As clinical pathways gain prominence in the oncology sphere, these data suggest a need for increased financial transparency among pathways developers, according to Robert Michael Daly, MD, assistant attending, thoracic oncology service, Memorial Sloan Kettering Cancer Center.

ASCO estimates suggest that 62% of oncology practices employed clinical pathway programs in 2015, with 31% of practices employing multiple pathways. Although both ASCO and the American Medical Association have raised concerns regarding financial conflicts of interest among pathway developers, little research has been conducted in this area.

Dr Daly and colleagues used the Centers for Medicare and Medicaid Services Open Payment database to abstract financial conflict of interest data from voting members, advisory board members, and oncology committee chairs at Value Pathways (a combined subsidiary of US Oncology and the National Comprehensive Cancer Network), Via Oncology, and eviti. The researchers recorded all nonresearch disclosures, including gifts, consultant fees, speakers fees, and honoraria.

Nonresearch general payments were common among members from all organizations, ranging from 92% of US Oncology pathway developers to 69% of eviti pathway developers. Average general payments ranged from $3500 (US Oncology) to $15,300 (National Comprehensive Cancer Network).

Forty-two percent of voting members from the National Comprehensive Cancer Network reported general payments of $10,000 or more, as did 28% of Via Oncology committee chairs, 19% of the eviti medical advisory board, and 8% of US Oncology voting members.

The researchers suggested potential methods to reduce the appearance of financial conflicts in pathway development, such as setting limits on nonresearch payment amounts and limiting the number of committee remembers receiving general payments. —Cameron Kelsall