Industry Payments in Academic Spine Surgery: Factors Associated with Various Types of Industry Payments in the Open Payments Database

Introduction: The recent establishment of the Open Payments Database (OPD) has allowed for a more transparent record of industry payments to physicians. Though some studies have been conducted to characterize distribution of industry payments from the Open Payments Database (OPD) among spine surgeons, the factors associated with various industry payments has not been well-studied. The objective of our study was to highlight associations between industry payments and surgeon descriptors, as well as investigate predictors for different types of industry payments.

Methods: A query was conducted of the North American Spine Society Spine Fellowship Directory from 2021-2022 to identify all orthopaedic or neurosurgical spine fellowship selection committee members for each program participating in the spine fellowship match. Additionally, we conducted a query of the Centers for Medicare and Medicaid Services (CSM) open payments website from 2015-2021 to collect payment records of spine fellowship selection committee members. Geographic location was split into four regions (Northeast, Southeast, Midwest, and West). Residency program rankings were split into four tiers (Top 25, 26-50, 51-100, Below 100). Bivariate analysis was performed to determine associations between industry payments and spine surgeon descriptors.

Results: We identified 310 orthopaedic and neurosurgical spine surgeons in our query search, representing 76 fellowship programs. Regression analysis identified total publications (p < 0.001), attending years (p < 0.001), and publication rate (p=0.017) as predictors of greater general payments. Total publications (p < 0.001), attending years (p < 0.001), and publication rate (p=0.040) were also predictors of higher royalties. Having a twitter account (p=0.018), being a director (p=0.034), total publications (p < 0.001), and publication rate (p < 0.001) were all predictive of greater consulting payments. Being a director (p=0.007) and being from the Southeast compared to Northeast (p=0.038) were associated with higher research payments. Total publications (p=0.788), attending years (p=0.746), and publication rate (p=0.882) had no significant association with education payments.

Conclusion : Research productivity and prominent social media presence are associated with industry payments outside of just research funding, including consulting payments and royalties. Education payment has no association with research productivity, social media presence, or residency program ranking.