In their article, the authors note that their previous analysis in 2013, which found out that 1 doctor had made $1 million and 21 doctors had made over $500,000 for the same reasons, was expected to be a wake-up call for more effective scrutiny, oversight, and challenges to these payments. Instead, these types of payments have become much more commonplace.

To identify the latest pharma millionaires and other spending trends, ProPublica analyzed more than 56 million payments made from 2014 to 2018 — the first five full years of the federal Open Payments initiative, which requires companies to publicly disclose the payments as part of the 2010 Affordable Care Act.

Some academics and physicians predicted that the exposure might cause companies to rethink making payments and doctors to rethink taking them. A flurry of studies matched the payment data with doctors' prescribing choices and found links between the payments and the products doctors chose.