Payments to Docs Correlate with ICD Choices: Study

Researchers from Yale University and several other academic centers say that in their study, a large proportion of first-time implantations of cardioverter-defibrillator ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) were performed by doctors who received payments from medical device manufacturers. “Patients were more likely to receive ICD or CRT-D devices from the manufacturer that provided the highest total payment to the physician who performed an ICD or CRT-D implantation than each other manufacturer individually,” the researchers say in the Journal of the American Medical Association.

The researchers write that the fundamental concern about industry payments to doctors is that such payments may change how doctors select treatment options and that their choices may not necessarily be consistent with the patient’s best interests.

Prior studies have demonstrated that doctor payments were associated with a greater likelihood of prescriptions for branded medications over generics, the study says. But investigators have not explored whether associations exist between payments from device manufacturers and device selection.

“A study specific to such devices is warranted because the factors that influence device selection may differ from medications,” the researchers write. “Among existing manufacturers of ICDs or CRT-Ds, there is no clear evidence of improved safety or efficacy for one manufacturer’s products over another’s. In this setting, physician payments from device manufacturers may influence device selections.”