Geographical and Temporal Trends in Industry Engagement Among Otolaryngologists 2017 to 2023

Objective: To identify trends in industry payments (IPs) to otolaryngologists from 2017 to 2023, particularly evaluating the impact of the COVID-19 pandemic. Study Design: Cross-sectional retrospective analysis. Setting: Open Payments Database. Methods: Non-research payments to otolaryngologists 2017 to 2023 were characterized by census region, nature of payment, submitting manufacturer, and temporal trends. Results: 448,093 transactions worth $85.6 million were found with a median payment per physician of $47.81. Payments sharply decreased in 2020 during the COVID-19 pandemic ($17.4 million/year pre-pandemic 2017 to 2019 to $7.7 million in 2020) but partially rebounded to $13.7 million/year by 2023. High-value payments (>$10,000) increased significantly post-pandemic (mean 124/year, 2021-2023) compared to pre-pandemic (mean 75/year, 2017-2020, P <.0001). Food and beverage were the most frequent payment type (88%; 17% of total value), but the greatest payment value came from consulting fees (2.6% of payments; 36% of total value). The top 5 states for industry payments (IPs) were California, Texas, New York, Florida, and Pennsylvania, accounting for 45% of nationwide IPs. The Northeast had the highest per-physician payments, whereas the South received the highest percentage (35%) of total funds. Twenty-six companies accounted for 80% of payments. Conclusions: The number of IPs decreased significantly during the COVID-19 pandemic but has approached pre-pandemic levels, driven by increased high-value payments. A small number of companies account for most payments. There is significant geographical heterogeneity, suggesting regional differences in physician-industry engagement and potentially disparate patient access to innovations. Future studies should clarify how industry funding influences otolaryngology clinical practice.