Medical device companies are paying UK hospitals millions of pounds to fund staff places, 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 they reported €425m (£367m at today’s rates) in payments to healthcare organizations in Europe between 2017 and 2019, according to the study in the journal Health Policy and Technology.
The businesses reported paying more than €37 million to hospitals and other healthcare bodies in the UK over the three-year period. The revelations include payments to some of England’s biggest hospital trusts.
James Larkin, one of the authors of the study and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the filings did not include consulting fees for medical staff and many companies did not register their payments. “This is just the tip of the iceberg,” he said. “There are a large number of payments that are not disclosed. The descriptions for payments that are made public are very vague and it is not entirely clear what they are for.”
There are concerns that payments from pharmaceutical and medical companies to health organizations may influence clinical decisions to use certain drugs and products. The Observer revealed last year that payments to UK health organizations and professionals will reach a record £200m in 2022.
Since 2016, the Association of the British Pharmaceutical Industry (ABPI) has published a database called Disclosure UK under which drug companies disclose payments to healthcare organizations and individuals. This does not include payments by medical device companies.
The new report analyzed the disclosure database of payments made by members of MedTech Europe, the European trade association representing the medical technology industry, from diagnosis to cure. The disclosures, reported on the transparentmedtech.eu database, covering educational grants, fellowships and public awareness campaigns.
Pharmaceutical multinational Johnson & Johnson disclosed the highest value of payments, with €184m to 27 countries. The American company Abbott Laboratories paid €44 million.
The report said: “These payments offer medical device companies the opportunity to provide a variety of [organisations] such as hospitals, universities and professional training bodies, all of which significantly influence healthcare practice.” It said the potential conflict of interest underscores the need for a publicly mandated disclosure database.
In the UK, Johnson & Johnson, which makes products including hip implants and surgical robotics, 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, made payments to at least five NHS hospital trusts. This includes 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 implantation programme.
A review published in July 2020 by Julia Cumberlege, entitled First Do No Harm, which examined how the health system in England responds to reports from patients about 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 influence medical practice and suggested a compulsory register. Last year the government held a consultation on the possible introduction of regulations mandating the disclosure of operating payments to the healthcare sector.
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Jonathan Evans, director of communications at the Association of British HealthTech Industries (ABHI), the UK’s leading trade body for health technology, said the relationship between medical device companies and healthcare professionals is crucial to improving safety and patient outcomes. He said: “There is a need 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 worker are reported to the NHS employer.
Johnson & Johnson said it is committed to transparency and supports mandatory disclosure of educational grants. Abbott Laboratories and Edwards Lifesciences have been contacted for comment.
Hospital trusts said they have strict policies to manage conflicts of interest and income received from working with medical device firms.
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 essential to the healthcare system and doctors are already expected to declare their conflicts of interest. Last autumn we consulted on proposals around the disclosure of industry payments to the healthcare sector. We are considering the responses to the consultation and a response will be published in due course.”
