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Many cardiac catheterization, electrophysiology lab directors receive big industry payments

Key clinical point: Many cardiac catheterization (CC) and electrophysiology (EP) laboratory directors receive notable industry payments that could create conflicts of interest.

Major finding: Nearly one-third of CC lab directors and nearly half of EP lab directors received payments of $10,000 or more in 2017.

Study details: An analysis of 2017 payments made to cardiac catheterization and electrophysiology lab directors from top U.S. hospitals via Open Payments Program data, compared with local interventional cardiologists and electrophysiologists.

Disclosures: Dr. Nihar R. Desai reported receiving funding from the Centers for Medicare & Medicaid Services, financial support from Johnson & Johnson, and research support from the American College of Cardiology Foundation. Dr. Jeptha P. Curtis reported receiving salary support from the American College of Cardiology, funding from the Centers for Medicare & Medicaid Services, and equity interest in Medtronic. No other authors reported any relevant financial disclosures. No funding for the study was reported.

Citation:

Annapureddy A et al. JAMA Intern Med. 2019 Jun 17. doi: 10.1001/jamainternmed.2018.8775.

Commentary:

Far too much about the purchasing of medical devices – and the costs passed to insurers and ultimately patients – is secretive and requires an overhaul, according to Rita F. Redberg, MD.

Noting that the results from the study by Annapureddy et al. found that nearly one-third of catheterization lab directors and one-half of electrophysiology lab directors receive more than $10,000 annually, she wrote that “the prevalence of financial relationships and the magnitude of the payments are of great concern.” Even picking up a meal can be influential, she added; imagine the impact of such a large payment.

What can be done? “Professional society guidelines should prohibit doctors with relationships with industry from participating in decisions about what devices their hospital chooses to purchase,” she stated, and patients should be made aware of relationships between doctors and device companies. More transparency, across the board, is necessary.

Dr. Redburg is a cardiologist at the University of California, San Francisco; she is interested in promoting high-value health care, which emphasizes delivering appropriate treatment while avoiding tests or therapies without known benefit. These comments are adapted from an editorial accompanying the article by Annapureddy et al. (JAMA Intern Med. 2019 Jun 17. doi:10.1001/jamainternmed.2018.8737). Dr. Redberg reported no conflicts of interest.