Gender disparities in industry payments to neurosurgeons: a comprehensive analysis of Centers for Medicare & Medicaid Services Open Payments data (2016-2022).

Abstract

Objective: This study aimed to investigate the extent of gender disparities in financial interactions between neurosurgeons and the medical device industry, examining the differences in the number, amount, and types of payments made to male and female neurosurgeons.

Methods: Utilizing data from the Centers for Medicare & Medicaid Services Open Payments database covering 2016-2022, the authors conducted a comprehensive analysis of industry payments to neurosurgeons. This methodology included univariate and multivariate analyses to examine the disparities in payments, with a focus on identifying significant differences in compensation across genders.

Results: An analysis of 24,074 industry transactions totaling $388,916,456.88 underscored pronounced gender disparities, with female neurosurgeons involved in merely 2.47% of these transactions and receiving just 0.91% of the overall financial value. The data revealed significant discrepancies in compensation between genders across all contributing companies. Male neurosurgeons engaged in a higher average number of annual transactions compared with their female counterparts (4.60 vs 2.75, p < 0.001), across various financial interactions. This included a greater participation in royalties and licenses (1.49 vs 0.31, p < 0.001), consulting fees (2.16 vs 1.63, p = 0.024), and acquisitions (0.01 vs 0.00, p = 0.006). On average, female neurosurgeons were compensated $16,303.66, starkly lower than the $75,523.20 average received by their male counterparts (p < 0.005). This gap was especially significant in royalties and licenses, where females earned an average of $5168.57 compared with $61,898.47 for males (p = 0.004). Additionally, in acquisitions, female neurosurgeons received no payments at all, whereas males averaged $2153.43 (p = 0.042). Several of these disparities remained significant even after accounting for potential confounding factors, highlighting a systematic bias in compensation and industry engagement against female neurosurgeons.

Conclusions: The study underscores a significant gender-based disparity in the financial interactions between neurosurgeons and the medical device industry. These disparities highlight the need for systemic changes to address the underlying factors contributing to inequity in compensation and industry collaboration opportunities. Implementing equitable compensation structures, mentorship programs, and inclusive policies is a crucial step toward achieving gender parity in neurosurgery and ensuring the field benefits from the diverse skills and perspectives of all its members.