Perelman School of Medicine at the University of Pennsylvania

Kanter Research

Selected Publications

A more complete list of publications is available at this Google Scholar profile and this NCBI PubMed profile.
 

Pham-Kanter G, Mello MM, Lehmann LS, Campbell EG, Carpenter D. 2017. Public Awareness of and Contact with Physicians Who Receive Industry Payments: A National Survey. Journal of General Internal Medicine 32:767-774.

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Abstract

Background

The Physician Payments Sunshine Act, part of the Affordable Care Act, requires pharmaceutical and medical device firms to report payments they make to physicians and, through its Open Payments program, makes this information publicly available.

Objective

To establish estimates of the exposure of the American patient population to physicians who accept industry payments, to compare these population-based estimates to physician-based estimates of industry contact, and to investigate Americans’ awareness of industry payments.

Design

Cross-sectional survey conducted in late September and early October 2014, with data linkage of respondents’ physicians to Open Payments data.

Participants

A total of 3542 adults drawn from a large, nationally representative household panel.

Main Measures

Respondents’ contact with physicians reported in Open Payments to have received industry payments; respondents’ awareness that physicians receive payments from industry and that payment information is publicly available; respondents’ knowledge of whether their own physician received industry payments.

Key Results

Among the 1987 respondents who could be matched to a specific physician, 65% saw a physician who had received an industry payment during the previous 12 months. This population-based estimate of exposure to industry contact is much higher than physician-based estimates from the same period, which indicate that 41% of physicians received an industry payment. Across the six most frequently visited specialties, patient contact with physicians who had received an industry payment ranged from 60 to 85%; the percentage of physicians with industry contact in these specialties was much lower (35–56%). Only 12% of survey respondents knew that payment information was publicly available, and only 5% knew whether their own doctor had received payments.

Conclusions

Patients’ contact with physicians who receive industry payments is more prevalent than physician-based measures of industry contact would suggest. Very few Americans know whether their own doctor has received industry payments or are aware that payment information is publicly available.

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Zinner DE, Pham-Kanter G, Campbell EG. 2016. The Changing Nature of Scientific Sharing and Withholding in Academic Life Sciences Research. Academic Medicine 91:433-440.

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Abstract

Purpose

Since 2000, federal funders and many journals have established policies requiring more open sharing of data and materials post-publication, primarily through online supplements and third-party repositories. This study examined changes in sharing and withholding practices among academic life scientists, particularly geneticists, between 2000 and 2013.

Method

In 2000 and 2013, the authors surveyed separate samples of 3,000 academic life scientists at the 100 U.S. universities receiving the most NIH funding. Respondents were asked to estimate the number of requests for information, data, and materials they made to and received from other academic researchers in the past three years. They were also asked about potential consequences of sharing and withholding.

Results

Response rates were 63.9% (1,849/2,893) in 2000 and 40.8% (1,165/2,853) in 2013. Proportions of faculty in 2000 and 2013 who received, denied, made, or were denied at least one request were not statistically different. However, the total volume of requests received from or made to other scientists dropped substantially (19.4 received in 2000 vs. 10.8 in 2013, P < .001; 8.4 made in 2000 vs. 6.6 in 2013, P < .001). Faculty in 2013 also made an average of 8.4 requests to third-party repositories. Researchers in 2013 were less likely to report that sharing resulted in new research or new collaborations.

Conclusions

The results show a dramatic shift in sharing mechanisms, moving away from a peer-to-peer sharing model toward one based on central repositories. This may increase efficiency, but collaborations may suffer if personal communication among scientists is deemphasized.

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Arias JJ, Pham-Kanter G, Campbell EG. 2015. The Growth and Gaps of Genetic Data Sharing Policies in the United States. Journal of Law and the Biosciences 2:56-68.

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Abstract

The 1996 Bermuda Principles launched a new era in data sharing, reflecting a growing belief that the rapid public dissemination of research data was crucial to scientific progress in genetics. A historical review of data sharing policies in the field of genetics and genomics reflects changing scientific norms and evolving views of genomic data, particularly related to human subjects’ protections and privacy concerns. The 2013 NIH Draft Genomic Data Sharing (GDS) Policy incorporates the most significant protections and guidelines to date. The GDS Policy, however, will face difficult challenges ahead as geneticists seek to balance the very real concerns of research participants and the scientific norms that propel research forward. This article provides a novel evaluation of genetic and GDS policies’ treatment of human subjects’ protections. The article examines not only the policies, but also some of the most pertinent scientific, legal, and regulatory developments that occurred alongside data sharing policies. This historical perspective highlights the challenges that future data sharing policies, including the recently disseminated NIH GDS Draft Policy, will encounter.

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Pham-Kanter G. 2014. Revisiting Financial Conflicts of Interest in FDA Advisory Committees. Milbank Quarterly 92: 446-70.

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Abstract

Context

The Food and Drug Administration (FDA) Safety and Innovation Act has recently relaxed conflict-of-interest rules for FDA advisory committee members, but concerns remain about the influence of members’ financial relationships on the FDA's drug approval process. Using a large newly available data set, this study carefully examined the relationship between the financial interests of FDA Center for Drug Evaluation and Research (CDER) advisory committee members and whether members voted in a way favorable to these interests.

Methods

The study used a data set of voting behavior and reported financial interests of 1,379 FDA advisory committee members who voted in CDER committee meetings that were convened during the 15-year period of 1997–2011. Data on 1,168 questions and 15,739 question-votes from 379 meetings were used in the analyses. Multivariable logit models were used to estimate the relationship between committee members’ financial interests and their voting behavior.

Findings

Individuals with financial interests solely in the sponsoring firm were more likely to vote in favor of the sponsor than members with no financial ties (OR = 1.49, p = 0.03). Members with interests in both the sponsoring firm and its competitors were no more likely to vote in favor of the sponsor than those with no financial ties to any potentially affected firm (OR = 1.16, p = 0.48). Members who served on advisory boards solely for the sponsor were significantly more likely to vote in favor of the sponsor (OR = 4.97, p = 0.005).

Conclusions

There appears to be a pro-sponsor voting bias among advisory committee members who have exclusive financial relationships with the sponsoring firm but not among members who have nonexclusive financial relationships (ie, those with ties to both the sponsor and its competitors). These findings point to important heterogeneities in financial ties and suggest that policymakers will need to be nuanced in their management of financial relationships of FDA advisory committee members.

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Pham-Kanter G. 2014. Act II of the Sunshine Act. PLoS Medicine 11: e1001754.

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Abstract

The Sunshine Act will lead firms to be more forthcoming about physician payments but will also create incentives for firms to underreport and target nonphysician prescribers. Whether transparency leads to diminished firm influence on doctors depends crucially on whether physicians who accept payments will be penalized by the public or other parties for accepting. Many preconditions must be met before patients can effectively sanction doctors for receiving payments.

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Pham-Kanter G, Zinner DE, Campbell EG. 2014. Codifying Collegiality: Recent Developments in Data Sharing Policy in the Life Sciences. PLoS One 9:e108451.

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Abstract

Over the last decade, there have been significant changes in data sharing policies and in the data sharing environment faced by life science researchers. Using data from a 2013 survey of over 1600 life science researchers, we analyze the effects of sharing policies of funding agencies and journals. We also examine the effects of new sharing infrastructure and tools (i.e., third party repositories and online supplements). We find that recently enacted data sharing policies and new sharing infrastructure and tools have had a sizable effect on encouraging data sharing. In particular, third party repositories and online supplements as well as data sharing requirements of funding agencies, particularly the NIH and the National Human Genome Research Institute, were perceived by scientists to have had a large effect on facilitating data sharing. In addition, we found a high degree of compliance with these new policies, although noncompliance resulted in few formal or informal sanctions. Despite the overall effectiveness of data sharing policies, some significant gaps remain: about one third of grant reviewers placed no weight on data sharing plans in their reviews, and a similar percentage ignored the requirements of material transfer agreements. These patterns suggest that although most of these new policies have been effective, there is still room for policy improvement.

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Gorlach I, Pham-Kanter G. 2013. Brightening Up: The Effect of the Physician Payment Sunshine Act on Existing Regulation of Pharmaceutical Marketing. Journal of Law, Medicine and Ethics 41:315-322.

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No abstract available

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Campbell EG, Pham-Kanter G, Vogeli C, Iezzoni LI. 2013. Physician Acquiescence to Patient Demands for Brand-Name Drugs: Results of a National Survey of Physicians. JAMA Internal Medicine 173:237-239.

No abstract available

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Pham-Kanter G, Alexander GC, Nair K. 2012. Effect of Physician Payment Disclosure Laws on Prescribing. Archives of Internal Medicine 172:819-821.

No abstract available

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