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Industry payments to physicians and advanced practice clinicians compared

More than a third of both groups accepted non-research payments in 2021

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Stephanie Lopez
Stephanie Lopez
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DURHAM, N.C. – The federal government has been tracking industry payments from pharmaceutical and medical device companies to doctors since 2013, but last year was the first time such numbers were tracked for advanced practice clinicians.

Advanced practice clinicians include nurse practitioners, physician assistants, certified registered nurse anesthetists, anesthesiologist assistants, certified nurse midwives, and clinical nurse specialists.

A new study led by Duke Health found that advanced practice clinicians received more payments from drug companies, while physicians accepted more funds from medical device companies. The same proportion of each group accepted payments, but the physicians received a much greater sum.

The findings are published in JAMA on Oct. 31. The study’s first author, Audrey Zhang, M.D., senior assistant resident in the Department of Medicine at the Duke University School of Medicine, said the results raise concerns about the ways industry may be influencing care.

"Receiving payments and developing relationships with an industry sponsor can encourage use of that sponsor’s products,” Zhang said. “The concern is when that practice affects the quality of patient care, especially if it incentivizes lower-value care.”

Among the study’s findings:

  • 35% of physicians accepted industry payments, including consulting fees;
  • 35.8% of advanced practice clinicians accepted payments, most often for food and beverages;
  • Payments made to physicians totaled $1.75 billion while payments to advanced practice clinicians totaled $119 million.

In addition to Zhang, Timothy S. Anderson, M.D., is also an author of the paper.

The research was funded by the National Institute of Aging (R38AGO65762 and K76AG074878).

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