CMS OPEN PAYMENTSThis analysis focuses on pharmaceutical transactions with physicians. We focused on General Payments to facilitate a better

apples-to-apples comparison. We wanted to spark thoughts and drive discussion on some of the intricacies of the data. This is just the starting point of evaluating ways that can help you spend your dollars more wisely and in greater compliance with industry practices.

Highlights of General Payments to Physicians from the Pharmaceutical Industry2015

OBSERVATIONS:• Vast majority of transfers are for meals (89%) represent

only 14% of the total value transferred

• CFSOTC, Consultant Fees, and Honoraria represent over 50% of the total value transferred

• Education is the third highest by volume

• 97% of Royalties or Licenses provided by Manufacturers where Industry = “Both” (n= 4,329)

METHODOLOGY:• Other (Both Charts) includes: Charitable Contribution, Non-CME

Faculty, CME Faculty, Ownership Interest, Entertainment, Gift, Grant, Space Rental or Facility Fees

• Other (Volume) additionally includes: Honoraria, Royalty• Other (Dollar) additionally includes: Education

50%Research

$3.2B

11%Ownership

$703M

39%General

$2.6B

21%TeachingHospitals

$543M

79%Physicians

$2B

Research Report does not include “delayed” payments

Ownership Report does notinclude publicly traded

companies

1 AM accounted for $255M in Royalties

34%Both

114 Companies$683M

30%Pharma

184 Companies$606M

34%Device

543 Companies$693M

Starting with

TOTAL SPEND BY REPORTThe 79% spend on Physicians comes from:GENERAL PHYSICIAN PAYMENTS

Spend by Industry

Of the 39% General Expenses:

GENERAL REPORTSpend by Recipient Type

NOTE:• 298/1018 AMs with reported General Payments are in the scope of this analysis• See Methodology and De�nitions section for our de�nitions of industry

2%Neither

177 Companies$33.4M

CMS OPEN PAYMENTSThis analysis focuses on the pharmaceutical industry's interaction with physicians. We focused on General Payments to facilitate a better

apples-to-apples comparison. We wanted to spark thoughts and drive discussion on some of the intricacies of the data. This is just the starting point of evaluating ways that can help you spend your dollars more wisely and in greater compliance with industry practices.

Overview of General Payments to Physicians from the Pharmaceutical Industry

2014Data

OBSERVATIONS:

General payments to physicians from companies with at least one pharmaceutical or biologic product represent 20% of the overall Open Payments universe:• Includes $1.3B in value across 9.9M transactions • The average payment amount is $130

WHAT TYPES OF PAYMENTS?

4% Travel & Lodging

3% Education

2% CFSOTC

1% Consulting Fees

1% Other

89%Food &

Beverage

NATURESBY VOLUME

NATURESBY DOLLAR

29%CFSOTC

17%Consulting

Fees

21% Royalty

14% Food & Beverage

9% Travel & Lodging

5% Other

4% Honoraria

HOW DO YOU COMPARE?

AVERAGE MEAL SPEND BY COMPANY†

OverallAverage =$2,387

$16K

$14K

$12K

$10K

$8K

$6K

$4K

$2K

†† 2 outlier companies are not included in the scatter plot

OverallAverage =$20

$200.00

$160.00

$180.00

$140.00

$120.00

$100.00

$80.00

$60.00

$40.00

$20.00

† 6 outlier companies are not included in the scatter plot

AVERAGE CONSULTING FEES BY COMPANY††

* 6 outlier companies are not included in the scatter plot

$2500

$2000

$1500

$1000

$500 OverallAverage =$60

‡ 7 outlier companies are not included in the scatter plot

$14K

$12K

$10K

$8K

$6K

$4K

$2KOverallAverage =$1,922

AVERAGE EDUCATIONAL ITEM VALUEBY COMPANY * AVERAGE CFSOTC BY COMPANY‡

EACH DOT REPRESENTS AN APPLICABLE MANUFACTURER FROM “PHARMA” OR “BOTH”

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

$20M

$60M

$40M

$80M

$100M

$140M

$120M

NATURES AMOUNT BY MONTH STATE SPEND PER CAPITA

OBSERVATIONS:• Royalties had largest variation• Minimal variation for CFSOTC, Consulting Fees, Food & Beverage, and All Other Natures

METHODOLOGY:• Divided total dollar amounts by state population – State based upon "Recipient State" – Population �gures from US Census

CFSOTC Consulting Fees Food & Beverage Royalty All Other Natures $0–0.99 $1.00–$1.99 $2.00–$2.99 $3.00–$3.99 $4.00–$11.99 $12.00+

TOP 10 DRUGS BY $ AMOUNT

OBSERVATIONS:• Orthopaedic Surgery and Neurological Surgery are outliers in terms of average payment• Internal Medicine and Family Medicine have highest volume with lower amounts

OBSERVATIONS:• 7/10 of the Top Drugs from 2013 remained in the Top 10 for 2014 (New: Bydureon, Botox, Brintellix)• 8/10 are co-marketed drugs• Several Specialties have multiple products: – Eliquis, Xarelto, and Brilinta are all Cardiovascular products – Abilify and Latuda are both Psychiatry & Neurology products – Bydureon and Invokana are both Endocrinology products

TOP 10 SPECIALTIES BY $ AMOUNT

TOTALS:

Rank

1

2

3

4

5

6

7

8

9

10

Specialty

Orthopaedic Surgery

Psychiatry & Neurology

Internal Medicine

Endocrinology, Diabetes & Metabolism

Cardiovascular Disease

Neurological Surgery

Hematology & Oncology

Obstetrics & Gynecology

Specialist

Family Medicine

# Products

555

635

924

448

546

356

503

575

729

826

Top Drug*

Equinoxe

Abilify

Bydureon

Bydureon

Eliquis

Acthar

Velcade

Osphena

Humira

Brintellix

Count

165K

1.09M

1.77M

283K

514K

57K

242K

256K

247K

6.9M

2.30M

$826M

Rank

1

2

3

4

5

6

7

8

9

10

Manufacturer(s)*

AstraZeneca, BMS

J&J, Animas, LifeScan

BMS, P�zer

J&J, Bayer, DePuy, Cordis

Allergan

Takeda, Lundbeck

AstraZeneca, Medicines

Otsuka, Lundbeck, BMS

Sunovion,Sumitomo Dainippon

AbbVie

Count

267K

181K

206K

239K

63K

164K

109K

334K

96K

110K

1.77M

Average

$92

$101

$85

$71

$257

$94

$141

$43

$139

$117

$93

METHODOLOGY:• The �rst 3 pie graphs �lter down payments to focus on General Payments to Physicians

from “Pharma” and “Both”, as shown below• Used "Submitting Applicable Manufacturer" for companies; consolidated common

corporate entities• Combined products and specialties with similar names, such as ("Abilify"/"Abilify

Depot") and ("Dentist"/"Dental Public Health")• Totals may not add up to 100% due to rounding

METHODOLOGY & DEFINITIONS

DEFINITIONS:NATURES:• “CFSOTC” = Nature 2; Compensation for services other than consulting, including serving as a

faculty or as a speaker at a venue other than a continuing education program• "Royalty" = Nature 10; Royalty or License• “Ownership” = Nature 11; Current or prospective ownership or investment interest• “Non-CME Faculty” = Nature 12; Compensation for serving as faculty or as a speaker for a

non-accredited and noncerti�ed continuing education program• “CME Faculty” = Nature 13; Compensation for serving as faculty or as a speaker for an

accredited or certi�ed continuing education program• "AM" = Applicable manufacturer

METHODOLOGY:• Specialties are grouped by name and the Drug listed has the highest dollar amount associated

with the specialty (transactions with blank product names were omitted for “Top Drug”)• Drugs are grouped by name and the Specialty listed has the highest dollar amount

associated with the drug

DC

*Based on "Name of Associated Covered Drug or Biologic 1” * When multiple manufacturers, they are listed in order by Dollar Amount

Top Specialty

Endocrinology,Diabetes & Metabolism

Endocrinology,Diabetes & Metabolism

Cardiovascular Disease

Cardiovascular Disease

Plastic Surgery

Family Medicine

Cardiovascular Disease

Psychiatry & Neurology

Psychiatry & Neurology

Dermatology

TOTALS:

Amount

$24.6M

$18.3M

$17.5M

$16.9M

$16.1M

$15.4M

$15.3M

$14.4M

$13.4M

$12.8M

$164.7M

Drug

Bydureon

Invokana

Eliquis

Xarelto

Botox

Brintellix

Brilinta

Abilify

Latuda

Humira

Total $

$216.2M

$123.8M

$87.5M

$68.7M

$62.7M

$55.6M

$47.0M

$43.9M

$42.5M

$78.1M

% of Total

16.8%

9.6%

6.8%

5.3%

4.9%

4.3%

3.6%

3.4%

3.3%

64.1%

6.1%

Avg. Payment

$1,311

$114

$49

$243

$122

$977

$195

$171

$172

$34

NAME OF DEVICEPOPULATED?

Yes

No Yes

No

NAME OF DRUGPOPULATED?

Device

Neither Pharma

BothINDUSTRY:

2014Data

Published by Potomac River Partners, July 2015