Ten-year analysis of non-research industry payments to anesthesiologists in the United States between 2014 and 2023

Anju Murayama

doi:10.1016/j.jclinane.2025.111742

Ten-year analysis of non-research industry payments to anesthesiologists in the United States between 2014 and 2023

J Clin Anesth. 2025 Jan 11:102:111742. doi: 10.1016/j.jclinane.2025.111742. Online ahead of print.

Author

Anju Murayama¹

Affiliation

¹ School of Medicine, Tohoku University, Sendai City, Miyagi 980-0872, Japan; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA. Electronic address: anju.murayama.s8@dc.tohoku.ac.jp.

PMID: 39799762
DOI: 10.1016/j.jclinane.2025.111742

Abstract

Study objective: This study aimed to examine extent, fraction, and trends of general payments to anesthesiologists and non-physician anesthesia providers (NPAPs) in the United States.

Design: This is a cross-sectional analysis of general payments by pharmaceutical and medical device industry to all anesthesiologists (2014-2023) and NPAPs (2021-2023) for non-research purposes using the Open Payments Database, a federal transparency database under the Physician Payments Sunshine Act between 2014 and 2023.

Setting: The United States.

Participants: All active practicing anesthesiologists and NPAPs, including certified registered nurse anesthetists and anesthesiologist assistants, in the United States.

Measurements: Fraction of providers receiving non-research payments; total payment amounts; median payment amounts per provider; relative annual average percentage change from 2014 to 2023.

Main results: A total of $297.8 million general payments were made by industry to 75.4 % of all active anesthesiologists from 2014 to 2023, while $7.2 million was made to 46.8 % of NPAPs from 2021 to 2023. Median annual payments ranged from $59-$120 for anesthesiologists and $37-$38 for NPAPs. The proportion of anesthesiologists receiving payments declined at a relative annual average percentage change (RAAPC) of -2.9 % from 2014 to 2019, followed by a substantial decrease in 2020. Subsequently, the number of payment recipients increased at an RAAPC of 15.4 % (2020-2023) for anesthesiologists and 9.0 % (2021-2023) for NPAPs. Payment distribution was highly concentrated, with the top 1 % of anesthesiologists and NPAPs receiving 78.2 % and 52.5 % of total payments in 2023, respectively. Among anesthesiology subspecialties, pain medicine physicians consistently received the highest median payments ($332-$767) throughout the study period.

Conclusions: This study demonstrated large financial relationships between industry and anesthesia providers, with a disproportionate concentration of payments among a minority of providers.

Keywords: Conflict of interest, pain medicine; Ethics; Open payments database; Physician payments sunshine act; United States.