Introduction: Financial relationships between neurosurgeons and industry partners are common. This study examines how industry payments vary by gender, region, payment type, and company to assess compensation differences.
Methods: Data from the CMS Open Payments Database from 2017-2023 was categorized by payment type and filtered for providers identifying themselves as neurological surgeons. Physician demographics, including gender, primary practice state, and subspecialty, were obtained from the CMS National Provider Identifier database and online searches. Descriptive statistics and multivariate linear regression assessed compensation disparities by gender and geography.
Results: Between 2017-2023, 8,845 neurosurgeons (7,669 [87.8%] male and 1,176 [15.3%] female) received $1,131,140,745 in industry payments. Royalties or ownership accounted for most total payments (75.8%), followed by consulting (8.8%), speaker fees (6.0%), acquisitions (5.7%), gifts (1.7%), research (1.4%), education (0.3%), and medical supply loans (0.2%). The top 15 highest-paid neurosurgeons accounted for 50.4% of all payments. Among the top 500 compensated, 69.7% specialized in spine, 11.0% neurovascular, 7.7% neuro-oncology, 4.6% functional, 2.7% skull base, 2.3% pediatric, and 2.1% neurotrauma surgery. The top five companies by payment were Medtronic ($242,258,549), Imperative Care ($135,757,255), Nuvasive ($66,396,580), Innovation Technologies ($47,015,17), and Triad Life Sciences ($46,400,391), accounting for most (50.2%) payments. Regression analysis revealed that male neurosurgeons received $27,179 more per capita than females (P < 0.01), and those practicing in the South received $32,425 more than those in the Midwest (P < 0.001).
Conclusion : Significant subspecialty, gender, and regional disparities in industry payments exist among neurosurgeons, informing efforts to achieve transparency and equity in these partnerships.
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