Financial ties between leaders of influential US professional medical associations and industry: cross sectional studyBMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1505 (Published 27 May 2020) Cite this as: BMJ 2020;369:m1505
- Ray Moynihan, assistant professor1,
- Loai Albarqouni, postdoctoral research fellow1,
- Conrad Nangla, research assistant1,
- Adam G Dunn, associate professor2,
- Joel Lexchin, professor emeritus3,
- Lisa Bero, professor4
- 1Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QLD, 4229, Australia
- 2Discipline of Biomedical Informatics and Digital Health, The University of Sydney, NSW, Australia
- 3School of Health Policy and Management, York University, Toronto, Canada
- 4Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Correspondence to: R Moynihan @raymoynihan on Twitter) (or
- Accepted 7 April 2020
Objective To investigate the nature and extent of financial relationships between leaders of influential professional medical associations in the United States and pharmaceutical and device companies.
Design Cross sectional study.
Setting Professional associations for the 10 costliest disease areas in the US according to the US Agency for Healthcare Research and Quality. Financial data for association leadership, 2017-19, were obtained from the Open Payments database.
Population 328 leaders, such as board members, of 10 professional medical associations: American College of Cardiology, Orthopaedic Trauma Association, American Psychiatric Association, Endocrine Society, American College of Rheumatology, American Society of Clinical Oncology, American Thoracic Society, North American Spine Society, Infectious Diseases Society of America, and American College of Physicians.
Main outcome measures Proportion of leaders with financial ties to industry in the year of leadership, the four years before and the year after board membership, and the nature and extent of these financial relationships.
Results 235 of 328 leaders (72%) had financial ties to industry. Among 293 leaders who were medical doctors or doctors of osteopathy, 235 (80%) had ties. Total payments for 2017-19 leadership were almost $130m (£103m; €119m), with a median amount for each leader of $31 805 (interquartile range $1157 to $254 272). General payments, including those for consultancy and hospitality, were $24.8m and research payments were $104.6m—predominantly payments to academic institutions with association leaders named as principle investigators. Variation was great among the associations: median amounts varied from $212 for the American Psychiatric Association leaders to $518 000 for the American Society of Clinical Oncology.
Conclusions Financial relationships between the leaders of influential US professional medical associations and industry are extensive, although with variation among the associations. The quantum of payments raises questions about independence and integrity, adding weight to calls for policy reform.
Contributors: All authors contributed to the planning, conduct, and reporting of this study. RM and LB are guarantors. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding: RM is supported by a research fellowship funded by the National Health and Medical Research Council (NHMRC grant No 1124207) and is a chief investigator on a Centre for Research Excellence (NHMRC grant No 1104136). LB funded in part by NHMRC (grant No 1139997). All authors had full access to all data and can take responsibility for the integrity of the data and the accuracy of the data analysis.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf. AGD reports grants from the National Library of Medicine, grants from National Health and Medical Research Council (NHMRC), outside the submitted work. JL reports that in 2016-19 he was a paid consultant on two projects: one looking at developing principles for conservative diagnosis (Gordon and Betty Moore Foundation) and a second deciding what drugs should be provided free of charge by general practitioners (Government of Canada, Ontario Supporting Patient Oriented Research Support Unit, and the St Michael’s Hospital Foundation). He also received payment for being on a panel at the American Diabetes Association, for a talk at the Toronto Reference Library, for writing a brief in an action for side effects of a drug, and for presenting at a workshop on conflict-of-interest in clinical practice guidelines for the Canadian Institutes of Health Research. He is currently a member of research groups that are receiving money from the Canadian Institutes of Health Research and the Australian NHMRC. He is member of the Foundation Board of Health Action International and the Board of Canadian Doctors for Medicare. He receives royalties from University of Toronto Press and James Lorimer for books he has written. LB reports grants from the NHMRC during the conduct of the study.
Ethical approval: This study was approved by the Bond University human research ethics committee (RM03089), and we stipulated that while working with publicly accessible data we would not name or describe any individual people in our results.
Data sharing: Deidentified simple summaries of data will be shared when possible and within confines of protocol and ethical approval conditions.
Dissemination to participants and related patient and public communities: We do not plan any participant dissemination as there were no participants and all data are already publicly available. We will widely disseminate the results of this study to professional colleagues and to the public, through conference and meeting presentations and media reporting.
The lead author (RM) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned (and, if relevant, registered) have been explained.
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