Advancing international comparison of pharmaceutical industry funding of patient advocacy: Focus on Denmark

Pharmaceutical industry funding of patient organizations raises ethical challenges related to patient engagement in healthcare due to fears of commercial agendas influencing patient advocacy and creating industry-driven inequalities across patient organizations. We contribute to an international body of knowledge on patient organization-industry relations by analyzing all payments reported by companies in Denmark over a six-year period, 2014-2019. We performed descriptive analyses calculating the number, value, and distribution of payments for various units of analysis: all companies and patient organizations; individual companies and patient organizations; and the broader disease area (e.g., cancer) and narrower disease (e.g., breast cancer). Fifty-one companies reported paying €8,826,916 to 84 patient organizations. As in previously studied countries, the funding was dominated by a relatively small number of funders and recipients, and commercially high-profile diseases attracted most of the funding. Nevertheless, our study also highlighted the arguably concerning dominance of one company in Denmark, both at the level of overall funding and in funding specific patient organizations, during a time of great policy contention surrounding one of its drugs, the world's top-selling medicine; i.e., switching patients to cheaper biosimilars to save big money for the healthcare system. Patient organizations have reasons to rethink some collaborations with companies, especially during policy contentions, and governments should ensure equitable funding to counteract risks posed by the concentration of industry funding.