Physician ownership and investment interests in oncology: A national analysis of open payments data (2018-2024).

e23024 Background: Financial relationships between physicians and industry raise concerns about conflicts of interest. The Physician Payments Sunshine Act requires pharmaceutical and medical device manufacturers to report these relationships to the Centers for Medicare & Medicaid Services (CMS) Open Payments program. Research into ownership, investment interests and oncology-specific analyses is limited despite long-term financial alignment and rapid therapeutic innovation. Methods: We conducted a retrospective observational analysis of physician ownership and investment interests using CMS Open Payments database from 2018–2024 in oncology-related specialties. General/research payments were excluded. Ownership was characterized by CMS-reported value of interest and amount invested. Differences across specialties and regions were assessed using Kruskal–Wallis tests with Dunn post-hoc comparisons, and temporal trends were evaluated using linear regression. Results: A total of 767 ownership/investment interests involving 127 physicians were reported by 43 drug and device manufacturers and GPOs. Hematologist-oncologists accounted for 60% of reports. The median ownership asset value was $5,000 (range $0–$2,106,176). 26% (n=200) of entries reported an investment in an applicable manufacturer/GPO in a year, with a median annual investment of $9,000 (range $15 to $946,498). Aggregate ownership asset value peaked in 2022 ($4.8 million). Significant variation was observed by region of physician and manufacturer/GPO (p < 0.001), with pediatric hematology-oncology demonstrating the highest median ownership value. One GPO, Cornerstone Specialty Network, accounted for 80% (n=611) of all ownership and investment reports. Conclusions: Physician ownership or investment interests in manufacturers/GPOs among physicians in oncology fields are rare, involving ~0.5% of physicians, with variability by specialty and geography. These findings highlight the importance of continued scrutiny of equity-based financial relationships in oncology. Descriptive statistics of the median value of ownership assets and investment amounts by specialty. Number of reports (%) Median value of ownership assets (IQR) Number of entries that report investments (%) Median amount invested on yearly basis (IQR) Hematology & Oncology 466 (61%) $5,000 ($3,479) 82 (18%) $9,000 ($5,122) Medical Oncology 175 (23%) $6,600 ($5,815) 49 (28%) $9,000 ($14,350) Radiation Oncology 99 (13%) $6,889 ($49,391) 57 (58%) $25,000 ($46,100) Gynecologic Oncology 11 (1%) $90,000 ($118,929) 4 (36%) $6,000 ($84,500) Surgical Oncology 11 (1%) $58,830 ($93,123) 5 (45%) $38,540 ($31,880) Pediatric Hematology-Oncology 5 (1%) $249,965 ($104,816) 3 (60%) $100,000 ($58,532)