Industry funding of patient and health consumer organisations: systematic review with meta-analysis

Abstract

ObjectiveTo investigate pharmaceutical or medical device industry funding of patient groups.DesignSystematic review with meta-analysis.Data sourcesOvid Medline, Embase, Web of Science, Scopus, and Google Scholar from inception to January 2018; reference lists of eligible studies and experts in the field.Eligibility criteria for selecting studiesObservational studies including cross sectional, cohort, case-control, interrupted time series, and before-after studies of patient groups reporting at least one of the following outcomes: prevalence of industry funding; proportion of industry funded patient groups that disclosed information about this funding; and association between industry funding and organisational positions on health and policy issues. Studies were included irrespective of language or publication type.Review methodsReviewers carried out duplicate independent data extraction and assessment of study quality. An amended version of the checklist for prevalence studies developed by the Joanna Briggs Institute was used to assess study quality. A DerSimonian-Laird estimate of single proportions with Freeman-Tukey arcsine transformation was used for meta-analyses of prevalence. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to assess the quality of the evidence for each outcome.Results26 cross sectional studies met the inclusion criteria. Of these, 15 studies estimated the prevalence of industry funding, which ranged from 20% (12/61) to 83% (86/104). Among patient organisations that received industry funding, 27% (175/642; 95% confidence interval 24% to 31%) disclosed this information on their websites. In submissions to consultations, two studies showed very different disclosure rates (0% and 91%), which appeared to reflect differences in the relevant government agency’s disclosure requirements. Prevalence estimates of organisational policies that govern corporate sponsorship ranged from 2% (2/125) to 64% (175/274). Four studies analysed the relationship between industry funding and organisational positions on a range of highly controversial issues. Industry funded groups generally supported sponsors’ interests.ConclusionIn general, industry funding of patient groups seems to be common, with prevalence estimates ranging from 20% to 83%. Few patient groups have policies that govern corporate sponsorship. Transparency about corporate funding is also inadequate. Among the few studies that examined associations between industry funding and organisational positions, industry funded groups tended to have positions favourable to the sponsor. Patient groups have an important role in advocacy, education, and research, therefore strategies are needed to prevent biases that could favour the interests of sponsors above those of the public.Systematic review registrationPROSPERO CRD42017079265.

Under-reported relationship: a comparative study of pharmaceutical industry and patient organisation payment disclosures in the UK (2012–2016)

“…There were three donors, constituting 3.6% of those in patient organisation data, whose payments were only reported in industry data (online supplementary files 10,11,12). The number and value of payments associated with these donors (in industry data) were 9 and £92 208.2, constituting 0.5% and 0.3% of the number and value of payments in patient organisation data.…”

“…2 Although industry funding may benefit patient organisations, 3 4 it raises concerns about potential conflict of interests (COIs) compromising patient organisations' independence and credibility. [5][6][7][8][9][10] Both donors 11 and recipients 4 assert that any COIs can be managed by careful disclosure of funding. On the donor side, since 2012 members of pharmaceutical industry trade groups in European countries, 12 such as the Association of the British Pharmaceutical Industry (ABPI), have disclosed payments to patient organisations annually on each company's website, including their monetary value and purpose.…”

Corporate sponsorship of patient groups

“…Given the considerable power of patient groups to influence healthcare policy and individual medical decision making, and given research documenting the effects of even small payments on physician practices,1 monetary relationships between patient groups and industry have prompted recent concern. In the linked paper (doi:10.1136/bmj.l6925), Fabbri and colleagues provide the first systematic review on this topic to examine the extent of ties between patient groups and industry, the policies of patient groups surrounding corporate sponsorship, and the effect of industry support on the public position statements made by patient groups 2. This builds on a recent qualitative study in The BMJ by Parker and colleagues exploring the attitudes of patient groups towards industry 3…”

“…At most, only two thirds had organizational policies to regulate industry funding. The results of four studies examining the association between group positions and corporate sponsorship show substantial divergence between funded and non-funded groups, which largely reflect differences in industry versus patient interests 2…”

“…These findings reveal the breadth and depth of relationships between patient groups and pharmaceutical and medical device companies. The issue is likely even more widespread than portrayed, as included studies only examined relationships with pharmaceutical and medical device companies, excluding connections with the food industry, health insurers, and other companies in the wellness sphere 2. Additionally, patient groups are not the only patient voices affected—individuals can become corporate sponsored influencers with no public disclosure of their commercial relationships 4…”