Royal colleges in the UK have received more than £9 million in marketing payments from drug and medical devices companies since 2015, but do not always disclose the payments publicly, finds an investigation published by the BMJ (2023).
Investigative journalist Hristio Boytchev asked the colleges to disclose all payments from industry, campaign groups or patient associations, including the specific amount received from each donor, but they all refused to do so except the Royal College of Anaesthetists, which did send a list of the payments it had received.
The other data was compiled from Disclosure UK, a website run by the Association of the British Pharmaceutical Industry (ABPI) and Transparent MedTech, run by MedTech Europe, the European trade association for medical device firms. This showed that pharmaceutical companies contributed £7.5 million in the years 2015–2022, with more than half going to the Royal College of Physicians (£2.8 million) and the Royal College of GPs (£2.4 million), mainly for sponsorship of events, donations and grants, and joint ventures. The biggest donor overall was Pfizer, with £1.8 million, followed by Novo Nordisk with £730 000 and Daiichi Sankyo with £478 000.
Medical devices companies declared a total of £1.7 million of payments to royal colleges for the years 2017 to 2021 for ‘educational grants’ and ‘support to educational events.’ The top recipient was the Royal College of GPs, with £674 000, followed by the Royal College Surgeons (England) with £414 000 and the Royal College of Surgeons of Edinburgh with £227 000. More than 90% of the money came from Johnson & Johnson and Thermo Fisher Scientific, who donated £905 000 and £644 000, respectively. The colleges told the BMJ that pharmaceutical and medical device company payments make up a fraction of their overall budgets and that there are clear governance rules around industry payments, while the companies said that all payments to royal colleges were disclosed transparently and were given with the goal of improving patient care.
Industry transparency initiatives are the only way the public can see payments from individual companies to the colleges, but experts say they have severe limitations. The ABPI, for example, only saves the data on payments for the most recent 3 years and deletes historical data.
Emma Hardy, Labour MP and chair of the All-Party Parliamentary Group on Surgical Mesh Implants, said: ‘I can see no justification for anything but full and mandatory disclosure. Medicine is literally a matter of life and death, and patients must be confident they are receiving the best treatment available for the right reasons’.
Margaret McCartney, a GP and former Royal College of General Practitioners trustee and council member, said, ‘Even if we are told the information is independent, funding skews the types of education or information that gets made. It means that we become less independent, because we are not setting our own priorities, and that’s bad for the profession.’
The UK Department of Health announced a public consultation on mandatory disclosure of industry payments to the healthcare sector – a system that already exists in the US as the Physician Payments Sunshine Act.
Susan Bewley, honorary professor emeritus in Obstetrics and Women’s Health at King’s College London said, ‘It is deeply disappointing that so many Royal Colleges negotiate these payments and don’t even tell the full and detailed truth about them. Patients need to trust medical institutions that educate, or create and implement guidelines which should be based on best available evidence, not lobbying. Sunshine, and full transparency are the very least’.