Medical device companies pay millions to the NHS as they promote products, says research

Medical device companies are paying millions of pounds to hospitals in Britain to fund staff placements, as well as training and awareness campaigns, while boosting sales of their products including implants, heart valves and diagnostic equipment, a new report reveals.

An analysis of disclosures by medical device companies found that they reported €425 million (£367 million at current rates) in payments to healthcare organizations in Europe between 2017 and 2019, according to the study in the journal Health policy and technology.

The companies reported that they have paid more than 37 million euros to hospitals and other healthcare institutions in Britain in the past three years. The disclosures include payments to some of the largest hospital trusts in England.

James Larkin, one of the study’s authors and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the submissions did not include consultancy fees for medical staff and that many companies do not record their payments. “This is just the tip of the iceberg,” he said. “There are a large number of payments that are not made public. The descriptions of the payments that are disclosed are very vague and it is not entirely clear what they are for.”

There are concerns that payments from pharmaceutical and medical companies to healthcare organizations could influence clinical decisions to use certain drugs and products. The Observer revealed last year that payments to UK health organizations and professionals would reach a record £200m by 2022.

Since 2016, the Association of the British Pharmaceutical Industry (ABPI) has published a database called Disclosure UK, in which pharmaceutical companies disclose payments to healthcare organizations and individuals. Payments by medical device companies are not included.

The new report analyzed the disclosure database that records payments made by members of MedTech Europe, the European trade association representing the medical technology industry, from diagnosis to cure. The revelations, logged into the transparentmedtech.eu database, includes education grants, scholarships and public awareness campaigns.

Pharmaceutical multinational Johnson & Johnson announced the highest value of payments, with €184 million to 27 countries. The American company Abbott Laboratories paid €44 million.

The report states: “These payments provide medical device companies with the opportunity to influence a range of organizations, such as hospitals, universities and professional training institutions, all of which have significant influence on healthcare practice.” It said the potential conflicts of interest highlighted the need for a publicly mandated disclosure database.

In Britain, Johnson & Johnson, which produces hip implants and surgical robotics, among other things, has made “educational” payments to several hospital trusts, including Guy’s and St Thomas’ NHS Foundation Trust, Barts Health NHS Trust and South Tees Hospitals NHS Foundation Trust. . US company Edwards Lifesciences, which makes heart valves, has made payments to at least five NHS hospital trusts. They include a 2022 grant of £67,650 to fund a “nurse educator” at King’s College Hospital NHS Foundation Trust to support the delivery of a valve implant programme.

A review published by Julia Cumberlege in July 2020, entitled First Do No Harm, which examined how the healthcare system in England responds to patient reports of side effects of treatments, raised concerns about payments from manufacturers to doctors and healthcare organizations.

Lady Cumberlege’s report said there was public concern that such payments could affect medical practice and proposed a mandatory register. Last year, the government held consultations on the possible introduction of regulations that would require the disclosure of sectoral payments to the healthcare sector.

Jonathan Evans, director of communications at the Association of British HealthTech Industries (ABHI), Britain’s leading health technology trade body, said the relationship between medical device companies and healthcare professionals is crucial to promoting safety and health. patient outcomes. He said: “This is necessary to support training, education and product development that can promote the best possible patient care.”

Evans added that under the ABHI code of practice, all transactions between a company and a healthcare provider were reported to the NHS employer.

Johnson & Johnson said it is committed to transparency and supported mandatory disclosure of education subsidies. Abbott Laboratories and Edwards Lifesciences have been contacted for comment.

Hospital trusts said they had strict policies in place to manage conflicts of interest and income from working with medical device companies.

Guy’s and St Thomas’ NHS Foundation Trust said: “We are one of the largest, most research-active trusts in the country, working with medical device companies to develop better treatments that improve the quality of care for our patients.”

A spokesperson for the Department of Health and Social Care said: “Transparency is vital to the healthcare system and doctors are already required to declare their conflicts of interest. Last autumn we consulted on proposals regarding the disclosure of sectoral payments to the healthcare sector. We are considering responses to the consultation and a response will be published in due course.”