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The Sunshine Act and oncology: Lessons learned from urology.

ABSTRACT: INTRODUCTION:The Physician Payment Sunshine Act was enacted to increase the transparency of financial relationships between physicians and the pharmaceutical industry. These financial relationships are prevalent in the field of oncology, as they are in other fields of medicine. We explored the relationship between industry and urologists for compensations associated with the treatment of urologic malignancies. METHODS:The publicly available Open Payments database was obtained from the Centers for Medicare & Medicaid Services. We performed a descriptive analysis of payments made to urologists for drugs associated with urologic malignancies. RESULTS:In total, 44,334 payments, summing to $ 4,638,856, were made to 5,666 urologists for drugs used to treat urologic cancers. The median payment per transaction was $14, and most (74.3%) were £ $20. Of the transactions, 39,368 (88.8%) were associated with drugs for prostate cancer, 3,475 (7.8%) for bladder cancer, and 1,491 (3.4%) for kidney cancer. Most payments were made the form of food or beverage (89%), equating to $826,667. CONCLUSIONS:For urologists, industry payments associated with cancer treatment are prevalent. Treatments for prostate cancer are associated with the most financial relationships, followed by bladder cancer and kidney cancer. Payments are small in amount, and are commonly in the form of food or beverage.

SUBMITTER: Maruf M

PROVIDER: S-EPMC8171588 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo investigate patterns of failure in institutional credentialing submissions to NRG/RTOG 1005 with the aim of improving the quality and consistency for future breast cancer protocols.Methods and materialsNRG/RTOG 1005 allowed the submission of 3-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), and simultaneous integrated boost (SIB) breast plans. Credentialing required institutions to pass a 2-step quality assurance (QA) process: (1) benchmark, requiring institutions to create a plan with no unacceptable deviations and ≤1 acceptable variation among the dose volume (DV) criteria, and (2) rapid review, requiring each institution's first protocol submission to have no unacceptable deviations among the DV criteria or contours. Overall rates, number of resubmissions, and reasons for resubmission were analyzed for each QA step.ResultsIn total, 352 institutions participated in benchmark QA and 280 patients enrolled had rapid review QA. Benchmark initial failure rates were similar for 3DCRT (18%), IMRT (17%), and SIB (18%) plans. For 3DCRT and IMRT benchmark plans, ipsilateral lung most frequently failed the DV criteria, and SIB DV failures were seen most frequently for the heart. Rapid review contour initial failures (35%) were due to target rather than organs at risk. For 29% of the rapid review initial failures, the planning target volume boost eval volume was deemed an unacceptable deviation.ConclusionsThe review of the benchmark and rapid review QA submissions indicates that acceptable variations or unacceptable deviations for the ipsilateral lung and heart dose constraints were the most commonly observed cause of benchmark QA failure, and unacceptable deviations in target contouring, rather than normal structure contouring, were the most common cause of rapid review QA failure. These findings suggest that a rigorous QA process is necessary for high quality and homogeneity in radiation therapy in multi-institutional trials of breast cancer to ensure that the benefits of radiation therapy far outweigh the risks.

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The Sunshine Act and oncology: Lessons learned from urology.

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