Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database

Piotr Ozieranski; Eszter Saghy; Shai Mulinari

doi:10.1371/journal.pone.0290022

Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database

Piotr Ozieranski, Eszter Saghy, Shai Mulinari

Research output: Contribution to journal › Article › peer-review

2 Citations (SciVal)

Abstract

INTRODUCTION: Although hospitals are key health service providers, their financial ties to drug companies are little understood. We examine non-research pharmaceutical industry payments to English National Health Service (NHS) trusts-hospital groupings providing secondary and tertiary care.

METHODS: We extracted data from the industry-run Disclosure UK database, analysing it descriptively and using the Jonckheere-Terpstra test to establish whether a statistically significant time trend existed in the median values of individual payments. We explained payment value and number per trust with random effects models, using selected trust characteristics as predictors.

RESULTS: Drug companies reported paying £60,253,421 to 234 trusts, representing between 90.0% and 92.0% of all trusts in England between 2015 and 2018. As a share of payments to all healthcare organisations, the number of payments rose from 38.6% to 39.5%, but their value dropped from 33.0% to 23.6%. The number of payments for fees for service and consultancy and contributions to costs of events increased by 61.5% and 29.4%. The median payment value decreased significantly for trusts overall (from £2,250.8 to £1,758.5), including those with lower autonomy from central government; providing acute services; and from half of England's regions. The random effects model showed that acute trusts received significantly more money on average than trusts with all other service profiles; and trusts from East England received significantly less than those from London. However, trusts enjoying greater autonomy from government did not receive significantly more money than others. Trusts also received significantly less money in 2018 than in 2015.

CONCLUSION: NHS trusts had extensive pharmaceutical industry ties but were losing importance as payment targets relative to other healthcare organisations. Industry payment strategies shifted towards events sponsorship, consultancies, and smaller payments. Trusts with specific service and geographical profiles were prioritised. Understanding corporate payments across the health system requires more granular disclosure data.

Original language	English
Article number	e0290022
Number of pages	27
Journal	PLoS ONE
Volume	18
Issue number	11 November
DOIs	https://doi.org/10.1371/journal.pone.0290022
Publication status	Published - 1 Nov 2023

Bibliographical note

Data Availability Statement: The data payment data that we analysed for the purposes of this article can be found as Figshare data repositories. Online Supplement 1 (DOI: https://doi.org/10.6084/m9.figshare.21316944) includes drug company payments to NHS trusts in England reported between 2015 and 2018, while Online Supplement 2 (DOI: https://doi.org/10.6084/m9.figshare.
21316944) - payments to HCOs which were nonNHS trusts during the same period. We share our entire code used for calculations in Online Supplement 3 (DOI: https://github.com/esaghy/NHS_Trust_analysis

Funding: This work was supported by The Swedish Research Council (VR), grant number 2020-01822 (“Following the money: cross-national study of
pharmaceutical industry payments to medical associations and patient organisations”). The grant was awarded to SM (PI) and PO (Co-I). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The details of the award can be accessed on the following website: https://www.vr.se/swecris#/project/2020-01822_VR. There was no additional internal and external funding received for this study.

Keywords

Disclosure
State Medicine
Conflict of Interest
England
Drug Industry

ASJC Scopus subject areas

General

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10.1371/journal.pone.0290022Licence: CC BY

Cite this

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title = "Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database",

abstract = "INTRODUCTION: Although hospitals are key health service providers, their financial ties to drug companies are little understood. We examine non-research pharmaceutical industry payments to English National Health Service (NHS) trusts-hospital groupings providing secondary and tertiary care.METHODS: We extracted data from the industry-run Disclosure UK database, analysing it descriptively and using the Jonckheere-Terpstra test to establish whether a statistically significant time trend existed in the median values of individual payments. We explained payment value and number per trust with random effects models, using selected trust characteristics as predictors.RESULTS: Drug companies reported paying £60,253,421 to 234 trusts, representing between 90.0% and 92.0% of all trusts in England between 2015 and 2018. As a share of payments to all healthcare organisations, the number of payments rose from 38.6% to 39.5%, but their value dropped from 33.0% to 23.6%. The number of payments for fees for service and consultancy and contributions to costs of events increased by 61.5% and 29.4%. The median payment value decreased significantly for trusts overall (from £2,250.8 to £1,758.5), including those with lower autonomy from central government; providing acute services; and from half of England's regions. The random effects model showed that acute trusts received significantly more money on average than trusts with all other service profiles; and trusts from East England received significantly less than those from London. However, trusts enjoying greater autonomy from government did not receive significantly more money than others. Trusts also received significantly less money in 2018 than in 2015.CONCLUSION: NHS trusts had extensive pharmaceutical industry ties but were losing importance as payment targets relative to other healthcare organisations. Industry payment strategies shifted towards events sponsorship, consultancies, and smaller payments. Trusts with specific service and geographical profiles were prioritised. Understanding corporate payments across the health system requires more granular disclosure data.",

keywords = "Disclosure, State Medicine, Conflict of Interest, England, Drug Industry",

author = "Piotr Ozieranski and Eszter Saghy and Shai Mulinari",

note = "Data Availability Statement: The data payment data that we analysed for the purposes of this article can be found as Figshare data repositories. Online Supplement 1 (DOI: https://doi.org/10.6084/m9.figshare.21316944) includes drug company payments to NHS trusts in England reported between 2015 and 2018, while Online Supplement 2 (DOI: https://doi.org/10.6084/m9.figshare. 21316944) - payments to HCOs which were nonNHS trusts during the same period. We share our entire code used for calculations in Online Supplement 3 (DOI: https://github.com/esaghy/NHS_Trust_analysis Funding: This work was supported by The Swedish Research Council (VR), grant number 2020-01822 (“Following the money: cross-national study of pharmaceutical industry payments to medical associations and patient organisations”). The grant was awarded to SM (PI) and PO (Co-I). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The details of the award can be accessed on the following website: https://www.vr.se/swecris#/project/2020-01822_VR. There was no additional internal and external funding received for this study. ",

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N1 - Data Availability Statement: The data payment data that we analysed for the purposes of this article can be found as Figshare data repositories. Online Supplement 1 (DOI: https://doi.org/10.6084/m9.figshare.21316944) includes drug company payments to NHS trusts in England reported between 2015 and 2018, while Online Supplement 2 (DOI: https://doi.org/10.6084/m9.figshare. 21316944) - payments to HCOs which were nonNHS trusts during the same period. We share our entire code used for calculations in Online Supplement 3 (DOI: https://github.com/esaghy/NHS_Trust_analysis Funding: This work was supported by The Swedish Research Council (VR), grant number 2020-01822 (“Following the money: cross-national study of pharmaceutical industry payments to medical associations and patient organisations”). The grant was awarded to SM (PI) and PO (Co-I). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The details of the award can be accessed on the following website: https://www.vr.se/swecris#/project/2020-01822_VR. There was no additional internal and external funding received for this study.

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N2 - INTRODUCTION: Although hospitals are key health service providers, their financial ties to drug companies are little understood. We examine non-research pharmaceutical industry payments to English National Health Service (NHS) trusts-hospital groupings providing secondary and tertiary care.METHODS: We extracted data from the industry-run Disclosure UK database, analysing it descriptively and using the Jonckheere-Terpstra test to establish whether a statistically significant time trend existed in the median values of individual payments. We explained payment value and number per trust with random effects models, using selected trust characteristics as predictors.RESULTS: Drug companies reported paying £60,253,421 to 234 trusts, representing between 90.0% and 92.0% of all trusts in England between 2015 and 2018. As a share of payments to all healthcare organisations, the number of payments rose from 38.6% to 39.5%, but their value dropped from 33.0% to 23.6%. The number of payments for fees for service and consultancy and contributions to costs of events increased by 61.5% and 29.4%. The median payment value decreased significantly for trusts overall (from £2,250.8 to £1,758.5), including those with lower autonomy from central government; providing acute services; and from half of England's regions. The random effects model showed that acute trusts received significantly more money on average than trusts with all other service profiles; and trusts from East England received significantly less than those from London. However, trusts enjoying greater autonomy from government did not receive significantly more money than others. Trusts also received significantly less money in 2018 than in 2015.CONCLUSION: NHS trusts had extensive pharmaceutical industry ties but were losing importance as payment targets relative to other healthcare organisations. Industry payment strategies shifted towards events sponsorship, consultancies, and smaller payments. Trusts with specific service and geographical profiles were prioritised. Understanding corporate payments across the health system requires more granular disclosure data.

AB - INTRODUCTION: Although hospitals are key health service providers, their financial ties to drug companies are little understood. We examine non-research pharmaceutical industry payments to English National Health Service (NHS) trusts-hospital groupings providing secondary and tertiary care.METHODS: We extracted data from the industry-run Disclosure UK database, analysing it descriptively and using the Jonckheere-Terpstra test to establish whether a statistically significant time trend existed in the median values of individual payments. We explained payment value and number per trust with random effects models, using selected trust characteristics as predictors.RESULTS: Drug companies reported paying £60,253,421 to 234 trusts, representing between 90.0% and 92.0% of all trusts in England between 2015 and 2018. As a share of payments to all healthcare organisations, the number of payments rose from 38.6% to 39.5%, but their value dropped from 33.0% to 23.6%. The number of payments for fees for service and consultancy and contributions to costs of events increased by 61.5% and 29.4%. The median payment value decreased significantly for trusts overall (from £2,250.8 to £1,758.5), including those with lower autonomy from central government; providing acute services; and from half of England's regions. The random effects model showed that acute trusts received significantly more money on average than trusts with all other service profiles; and trusts from East England received significantly less than those from London. However, trusts enjoying greater autonomy from government did not receive significantly more money than others. Trusts also received significantly less money in 2018 than in 2015.CONCLUSION: NHS trusts had extensive pharmaceutical industry ties but were losing importance as payment targets relative to other healthcare organisations. Industry payment strategies shifted towards events sponsorship, consultancies, and smaller payments. Trusts with specific service and geographical profiles were prioritised. Understanding corporate payments across the health system requires more granular disclosure data.

KW - Disclosure

KW - State Medicine

KW - Conflict of Interest

KW - England

KW - Drug Industry

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Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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Following the money: cross-national study of pharmaceutical industry payments to medical associations and patient organisations

Cite this

Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Projects

Following the money: cross-national study of pharmaceutical industry payments to medical associations and patient organisations

Cite this