• Quinn Grundy, Fabian Held, Dana Hart, Christine M Baugh, Elissa Ladd, Eric Campbell, and Lisa Bero.
• Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. quinn.grundy@utoronto.ca.
• J Gen Intern Med. 2024 May 1; 39 (7): 114211481142-1148.

BackgroundThe pharmaceutical industry promotes prescribing through the cultivation of key opinion leaders. Advanced practice nurses (APNs) are a growing and influential group of prescribers across generalist and specialty practice. Public reporting of industry payments to APNs allows for exploration of their influence within practice settings.ObjectiveTo understand the characteristics of APNs with top industry payments including their positions of influence and other payment recipients at the same address.Design And SettingCross-sectional study of US national Open Payments reports of industry payments made between January 1, 2021, and December 31, 2021.ParticipantsAPNs who received > $50,000 USD in industry payments for speaking, consulting, and honoraria ("personal fees").MeasuresDescription of top APN recipients' practice setting type, clinical specialty, presence of other payment recipients, value of payments attributed to the same address, and top manufacturers and therapeutic categories associated with payments to top APN recipients. Structured content analysis of public-facing websites for evidence of APNs' clinical, research, and teaching leadership.ResultsA total of 99 APNs received > $50,000 USD in aggregate personal fees and a median $74,080 USD (IQR $57,303-101,702) in aggregate payments. They shared a practice setting with a median of 1 (IQR 0-5) physician and 0 (IQR 0-3) other APN payment recipients and were often the only (39%, 42/109) or the dominant (45%, 30/67) payment recipient in their practice setting. In total, 36% held clinical leadership positions, 25% led scientific research, and 18% had university appointments. Forty-two percent (37/88) owned a clinical practice, including cosmetic clinics (51%, 19/37) and mental/behavioral health clinics (24%, 9/37).ConclusionsTop APN payment recipients attracted high-value payments in practice settings and specialities associated with high-cost drug development; however, there may be little oversight of APNs' industry relationships. Policy development related to industry relationships must be inclusive of and responsive to the activities of interprofessional providers.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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