E.Saghy_research data.zip

Although there has been extensive research on pharmaceutical industry payments to healthcare professionals, healthcare organisations with key roles in health systems have received little attention. We seek to address this gap in research by examining drug company payments to general practice surgeries in England in 2015. We combine a publicly available payments database, the Disclosure UK, managed by the pharmaceutical industry with datasets covering key surgery characteristics and a database of unethical company marketing practices. We find that surgeries were an important target of company payments, receiving £2,726,017.77, equivalent to 6.53% of the value of payments to all healthcare organisations in England. Payments to surgeries were highly concentrated. The top 10 donors and the top 10 recipients amassed 87.93% and 13.62% of the value of payments, respectively. While some companies made fewer but higher value payments, others made more frequent low value payments. Surgeries with more patients, a greater proportion of elderly patients, and those in more deprived areas received more payments on average. However, the patterns of payments were similar across England’s regions. We also found that company networks – established by making payments to the same surgeries – were largely dominated by a single company, which was also by far the biggest donor. This company was the target of several investigations into the unethical marketing of a novel-type of anticoagulant increasingly prescribed by surgeries, suggesting that its payments might be connected to this drug’s marketing. Our research demonstrates that the comprehensiveness and quality of payment data disclosed via industry self-regulatory arrangements needs improvement. More interconnectivity between payment data and other datasets is needed to capture company marketing strategies systematically. Greater policy attention is necessary to the risk of financial dependency and conflicts of interests that might arise from payments to surgeries and to organisational conflicts of interests more broadly.