High Industry Payments to Hemophilia Center Directors May Be Cause for Concern

Eighty percent of hemophilia physicians in the United States received some amount of payment from the drug and medical device industry over the years 2018 through 2020, with center directors receiving the most, according to study results published in Thrombosis Research.

“Physicians who treat hemophilia, and especially directors at hemophilia centers, are in a position to be unduly influenced by payments from pharmaceutical companies who make costly hemophilia drugs,” explained a research team from the department of epidemiology and biostatistics at University of California San Francisco. “It is from this perspective that we analyzed payments made to physicians at hemophilia centers in the United States.”

Researchers identified a total 420 physicians in the Centers for Disease Control and Preventions’ Hemophilia Treatment Center Directory. For each physician, the research team searched the US Centers for Medicare & Medicaid Services’ Open Payments website to identify any payments made by drug and medical device companies for the years 2018 through 2020 and then calculated 1-year averages. The analysis included 270 physicians/professors, 103 directors of hemophilia centers, and 47 division or other directors. 

Median 1-year general payments were $4910 for directors of hemophilia centers, according to the study, compared with $79 for other directors and $87 for physicians/professors.

“While it was beyond the scope of our project to assess prescribing practices of directors of hemophilia centers, there is cause for concern that the higher industry payments to directors could bias treatment decisions made at hemophilia treatment centers,” researchers wrote, “thus putting the interests of the centers above those of the patients.” 

The three companies with the most payments to physicians, the study found, were the three companies with the largest hemophilia drug market share: Takeda Pharmaceutical Company Limited, F-Hoffmann La Roche Ltd./Genentech, and Novo Nordisk.

“Future studies should assess whether high payments, especially among individuals who have responsibility over the success of hemophilia centers and clinics, may result in competition with the interest of the patients at these centers and clinics,” researchers wrote.

Reference:
Haslam A, Prasad V. Cross-sectional analysis of open payments for physicians at designated hemophilia centers in the US (2018-2020). Thromb Res. 2023;227:40-44. doi: 10.1016/j.thromres.2023.05.002