STUDY OBJECTIVE: This study aimed to examine extent, fraction, and trends of general payments to anesthesiologists and non-physician anesthesia providers (NPAPs) in the United States. DESIGN: This is a cross-sectional analysis of general payments by pharmaceutical and medical device industry to all anesthesiologists (2014-2023) and NPAPs (2021-2023) for non-research purposes using the Open Payments Database, a federal transparency database under the Physician Payments Sunshine Act between 2014 and 2023. SETTING: The United States. PARTICIPANTS: All active practicing anesthesiologists and NPAPs, including certified registered nurse anesthetists and anesthesiologist assistants, in the United States. MEASUREMENTS: Fraction of providers receiving non-research payments
total payment amounts
median payment amounts per provider
relative annual average percentage change from 2014 to 2023. MAIN RESULTS: A total of 97.8 million general payments were made by industry to 75.4 % of all active anesthesiologists from 2014 to 2023, while .2 million was made to 46.8 % of NPAPs from 2021 to 2023. Median annual payments ranged from 9- 20 for anesthesiologists and 7- 8 for NPAPs. The proportion of anesthesiologists receiving payments declined at a relative annual average percentage change (RAAPC) of -2.9 % from 2014 to 2019, followed by a substantial decrease in 2020. Subsequently, the number of payment recipients increased at an RAAPC of 15.4 % (2020-2023) for anesthesiologists and 9.0 % (2021-2023) for NPAPs. Payment distribution was highly concentrated, with the top 1 % of anesthesiologists and NPAPs receiving 78.2 % and 52.5 % of total payments in 2023, respectively. Among anesthesiology subspecialties, pain medicine physicians consistently received the highest median payments ( 32- 67) throughout the study period. CONCLUSIONS: This study demonstrated large financial relationships between industry and anesthesia providers, with a disproportionate concentration of payments among a minority of providers.