Abstract Background Skin substitutes are vital in burn care. While physician-industry partnerships drive innovation and access, they also raise concerns regarding bias and conflicts in product promotion. This study analyzes current trends in physician-company financial relationships within the skin substitute market related to burn treatment. Methods The Physician Payments Sunshine Act mandates transparency in reporting industry payments to physicians. Companies with the largest market share of skin substitutes and burn wound coverage products were evaluated. Physician payment records from 2017 to 2023 were extracted and analyzed by category, including consulting fees, speaker compensation for non-accredited education, food and beverage, and travel. Results Eight companies representing 28 products distributed nearly 45 million in direct payments to physicians over six years; company totals varied by up to 13. 5 million. Annual per-physician payments ranged from 0. 35 to 1, 088, 405. 68 (median 47. 17, IQR 21. 44 to 130. 57). The highest expenditure categories were non-accredited speaker compensation (2, 741, 643. 65/year), which declined during COVID-19, and consulting fees (1, 046, 408. 71/year), which remained stable. Excluding pandemic years (2020-2021), total annual payments ranged from 3, 233. 73 to 4, 379, 242. 77 (median: 115, 052. 45). Only two companies, Kerecis and Avita, demonstrated consistent increases in payments over the past three years. Conclusion Physician payments in the skin substitute market vary widely. The wide variability—from negligible sums to over a million dollars—questions the adequacy of blanket disclosure statements as a meaningful representation of physician involvement in research and product promotion. These findings suggest opportunity for greater transparency in disclosure statements.
Smith et al. (Wed,) studied this question.