Drug and device makers paid nearly $6.5 billion in payments to doctors and teaching hospitals last year, according to the latest figures released on Thursday from a federal database. And physicians or their family members held $1 billion in ownership or investment interest in those companies.

Novartis topped the list with more than $539 million reported in payments to health care providers, a big jump from $302 million in 2014, according to the Open Payments database maintained by the US Centers for Medicaid & Medicare Services. Next was Genentech, which reported $470.3 million. In 2014, Genentech led the pack at nearly $385 million.

In third place was Pfizer, with more than $436 million, although the company filed the largest number of reports. A spot check of the database indicated most drug makers did not report ownership and investment interests. Publicly held companies are not required to report ownership and investment interests, CMS tells us.

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Meanwhile, CMS found that nearly 2.3 percent of all financial transactions between doctors and drug makers were related to opioids.

As for physicians, the highest-paid specialist were those working in nuclear medicine — they received average payments of more than $51,200, followed by neurological surgeons, whose average payments were $26,100. In 2014, orthopedic surgeons received the highest average payment, which was nearly $34,600, but that fell to slightly to less than $26,100 last year. Radiologists ranked fourth in 2015, with average payments of nearly $19,600.

The database was created under the Sunshine Act provision of the Affordable Care Act in response to concerns that industry payments to doctors may unduly influence medical practice and research. Drug and device makers are required to report provide transaction data to Open Payments, which was launched in September 2014. The database initially covered part of 2013 and all of 2014. On Thursday, however, CMS provided 2015 transaction data for the first time.

Overall, CMS said that drug and device makers reported $7.52 billion in payments and ownership and investment interests to physicians and teaching hospitals. The agency counted 11.9 million total records attributable to nearly 619,000 physicians and more than 1,100 teaching hospitals.

The agency said there were more than 11.1 million transactions totaling $2.60 billion in general payments – those not related to medical research. This was down from nearly 11.2 million transactions worth $2.64 billion in 2014.

There were also more than 764,600 transactions totaling $3.89 billion in research payments, compared with nearly 673,000 transactions totaling $3.79 billion in 2014.

And the database shows $1.03 billion of ownership or investment interests held by physicians or their immediate family members, down slightly from $1.06 billion reported in 2014.

A Novartis spokesman said “we consult doctors to get their insights and advice on diseases and products to help ensure we’re developing medicines that meet the needs of patients. We facilitate programs where physicians who are experts in their fields meet with their peers to help educate them about the appropriate use of FDA-approved medicines; this helps physicians make informed prescribing decisions with their patients.”

Interestingly, there was a notable shift toward charitable contributions and fewer payments to doctors in the form of honoraria and gifts. In terms of dollar value, companies increased charitable contributions on behalf of physicians by more than 120 percent.

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Payments for food and beverage; travel and lodging, and consulting fees were either flat or declined very slightly. Payments for honoria fell by roughly 50 percent and by more than 30 percent for gifts, in dollar terms, according to CMS.

Overall, about one-tenth of 1 percent of the records or more than 16,600 — were disputed by physicians, accounting for 1.95 percent of the total value of published records, according to CMS.

This story was updated to reflect a spot check of the database for ownership and investment interests that may have been reported by drug makers.

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