Payments by category and payment concentration
Payments for lecturing occupied for 86.3% of overall monetary values ($11,968,045) and 84.8% of overall payment contracts (18,714 contracts) between 2016 and 2019. Of 8,190 eligible otorhinolaryngologists, 3,373 (41.2%), 1,112 (13.6%), and 494 (6.0%) received one or more compensation payments for lecturing, consulting, and writing from the pharmaceutical companies over the four years, respectively.
While majority of otorhinolaryngologists did not receive any payments from the pharmaceutical companies over the four years, top 1%, 5%, 10%, and 25% of otorhinolaryngologists received 42.3% (95% confidence interval [95% CI]: 37.2%–47.4%), 69.3% (95% CI: 65.9%–72.8%), 80.6% (95% CI: 78.3%–82.9%), and 94.8% (95% CI: 94.1%–95.5%) of overall payments, respectively. (Supplemental Material 2) The Gini coefficient for four-year combined payments per physician was 0.889, indicating that the payments disproportionately concentrated on small numbers of otorhinolaryngologists.