UCSF

Introduction

Physicians who treat hemophilia, and especially directors at hemophilia centers, are in a position to be unduly influenced by payments from pharmaceutical companies who make costly hemophilia drugs. It is from this perspective that we analyzed payments made to physicians at hemophilia centers in the US, focusing on center directors.

Materials and methods

In a cross-sectional analysis we searched the CDC's Hemophilia Treatment Center Directory for physicians (2022) and then abstracted general payments for physicians on Open Payments (2018-2020) and calculated one-year average payments. We searched academic websites to determine physician role (hemophilia center director, non-director, or non-center director).

Results

There were 420 physicians in the hemophilia physician directory - 270 physicians/professors, 103 directors of hemophilia centers, and 47 other directors. Directors of hemophilia centers had higher median one-year general payments, compared to other directors and physician/professors ($4910 vs $79 vs $87, respectively; p < 0.0001). Takeda Pharmaceutical Company Limited, F-Hoffmann La Roche Ltd./Genentech, and Novo Nordisk have the largest hemophilia drug market share and were the three companies with the most payments to physicians.

Conclusions

High payments, especially among individuals who have responsibility over the success of hemophilia centers and clinics, may result in competition with the interest of the patients at these centers and clinics.