Study Examines Neurosurgeon Ties to Industry

Medical device manufacturers and pharmaceutical companies work closely with doctors by funding their research, sending them to conferences, and giving them early access to new drugs and devices. A recent study led by Dr. Aladine Elsamadicy, MD, a third-year neurosurgery resident at the Yale School of Medicine, seeks to make the financial value of this relationship transparent, especially as it relates to neurosurgeons.

“No one understands the magnitude of the financial side of industry’s relationship with medicine and how much that interplays with practice,” says Dr. Elsamadicy. He believes in openness around the interplay between medicine and industry and has undertaken a pioneering new study to understand this complex relationship better.

In “Characteristics of Reported Industry Payments to Neurosurgeons: A 5-Year Open Payments Database Study,” Dr. Elsamadicy looks at data from the Open Payments Database. He found that 105,150 surgeons across the U.S and 13,668 neurosurgeons received industry payments from 2014 to 2018. Neurosurgeons were the second-highest-paid by industry — behind orthopedic surgeons — with 421,151 industry payments totaling $477,451.070 over those five years.

Dr. Elsamadicy says both orthopedic surgeons and neurosurgeons frequently use biomedical devices, and industry helps drive innovation in this sector. Neurosurgeons rely on devices such as spinal implants, stents to treat vascular conditions such as stroke, and devices used to treat brain tumors.

The largest proportion of payments went towards food and beverage, followed by travel and lodging — 75.5% and 14.9%, respectively. But the most amount of money was paid out for royalties and licensing, with $305,517,489 being given to neurosurgeons, followed by consulting fees, which garnered $56,445,950.

Dr. Elsamadicy says his study doesn’t seek to judge or draw conclusions about industry payments to surgeons but makes the industry support in neurosurgery more transparent.

Dr. Charles Matouk, MD, assistant professor of neurosurgery and radiology & biomedical imaging at Yale University, and one of the paper's authors echoes that sentiment. “A strong relationship between industry and medical doctors drives innovation and better patient care. But its dark underbelly is conflict of interest — often insidious and difficult to pin down,” he wrote on social media about the study.

On the upside, industry money can help young researchers get funding for their work and start building a research program, says Dr. Elsamadicy. When for-profit companies work with doctors, they can innovate and discover and test new devices and drugs.

But being affiliated with industry can impact a doctor’s status in the medical community. For instance, ties with industry could influence physicians to exaggerate data in industry-funded studies.

He says a possible follow-up study could look at patient outcomes when an industry is involved. But until that data comes in, Dr. Elsamadicy says his study can only quantify these relationships' existence.

Other Yale contributors to the study include Andrew B. Koo, MD, Benjamin C. Reeves, Christopher S. Hong, MD, Luis Kolb, MD, Maxwell Laurans, MD, and Michael DiLuna, MD.