Pharma pours millions into the NHS for non-research work—but we don’t know what the money is being spent on

Many industry payments to NHS organisations are unexplained and disclosure figures can’t be trusted. This raises questions about unrecognised conflicts of interest, find Hristio Boytchev , Piotr Ozieranski , and Mostafa Elsharkawy An analysis by The BMJ has found that pharmaceutical companies pay tens of millions of pounds to the NHS each year without the public being told what the payments are for. The findings have led to calls for a shake-up of current transparency rules so that patients can see why payments are being made to the NHS. Pharmaceutical companies paid £156m to NHS trusts in England between 2015 and 2022, according to new analysis of the Disclosure UK database. The Association of the British Pharmaceutical Industry (ABPI) database requires participating companies to disclose cash payments and other benefits in kind to healthcare professionals and organisations. Even though the scheme has been lauded as one of the best among its industry run peers in Europe,1 The BMJ has uncovered widespread confusion about the intended purpose of the payments. For example, if any of these payments are for “educational” purposes that could be linked to the promotion of pharmaceutical products. “There is a big difference between publishing some numbers and creating effective transparency,” says Margaret McCartney, a general practitioner and transparency campaigner. She questions if it is “in the patient and public interest that such massive transfers of value are occurring between the pharmaceutical industry and the NHS.” “When companies dole out over £156m, they aren’t doing it out of the goodness of their hearts, they are doing it because they expect some kind of return on their investment. The unanswered question, so far, is what they want,” comments Joel Lexchin, professor emeritus at the school of health policy and management at York University, Toronto, Canada. “Transparency is key …