Annapureddy et al. examined data from more than 145,000 patients who received an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D) from 2016 to 2018. More than 4,000 physicians were included in the study, and 94% of them had received payments from at least one device manufacturer. The median payment received was $1,211.
Of the physicians who did receive payments, 8% received payments from a single manufacturer, 17% received payments from two manufacturers, 37% received payments from three manufacturers and 37% received payments from all four manufacturers tracked for this analysis.
Overall, the team found, somewhere between 38.5% and 54.7% of patients received ICDs and CRT-Ds made by the manufacturer that provided their physician with the largest payments. A vast majority of those patients—96% to be exact—underwent implantations at a hospital where devices made by more than one manufacturer were available.
One key point, the authors emphasized, is that the rates of in-hospital mortality or complications did not appear to be impacted by the presence of payments. However, the data still provides reasons to be concerned about the decision-making processes of some physicians.
“This study’s findings raise the possibility that payments from device manufacturers may influence the physician’s choice in selection of a manufacturer’s device,” the authors wrote. “However, this may not be the only contributing factor. Physicians who perform ICD or CRT-D implantations may develop a preference for a specific line of products based on years of experience and familiarity. Working with a small number of devices may improve efficiency of clinical care, particularly in the outpatient setting.”
Annapureddy and colleagues noted that their study did have certain limitations, including one important point about the timing of these payments.
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