Drawing on research, international practices and documented cases of avoidable patient harm, a new Institute for Policy Research (IPR) policy brief by a team of international academic researchers and UK-based patient advocates recommends key legislative reforms to enhance financial transparency in industry-NHS collaborations.

Pharmaceutical and medical companies have extensive collaborative ties to the healthcare sector across the UK. The UK Government’s recent International Investment Summit included the announcement of a £279 million investment from pharmaceutical industry giant Eli Lilly and Company, intended to tackle major health challenges such as obesity.

These collaborations can indeed lead to innovation but can also generate conflicts of interest that can put patient health at risk and waste NHS resources, as demonstrated, for example, by the harms caused by the pelvic mesh scandal.

The authors of the policy brief argue that for genuinely transformative partnerships to thrive, full transparency is needed so that policymakers and members of the public can understand the nature of such partnerships and make their own judgement about whether they benefit the NHS.

Dr Piotr Ozieranski from the Department of Social and Policy Sciences, University of Bath, said:

‘While transparency is not sufficient to address the risks of conflicts of interest, it is a first and necessary step. In the UK, conflicts of interest are not effectively disclosed and managed because the process is left in the hands of the industry. The Government’s drive to secure more industry investment in healthcare needs to be matched by its firm commitment to achieving full transparency of industry-NHS collaborations.’

The policy brief is published against the backdrop of a new investigation from The BMJ, which reveals that drug companies paid an estimated £156m to NHS trusts in England between 2015 and 2022, without the public being told what the payments were for. Widespread problems with the accuracy of payments reported by the companies raise concerns about conflicts of interests escaping public scrutiny and have led to calls for a shake-up of current transparency rules.

In late 2023, the Government ran a consultation on improving the current system for disclosing these financial ties to the public, but the authors of the policy brief say that the Government’s proposals offer only modest improvements.

Instead, the authors recommend legislative changes in three key areas:

  • Full disclosure of all financial ties between industry and the healthcare sector, covering payments for research, ownership interests and hospitality.
  • A centralised, government-run disclosure database ensuring reliable, high-quality payment data for patients, regulators and policymakers.
  • A user-friendly interface and tools to allow all stakeholders to search and interpret financial flows and identify potential conflicts of interest.

These reforms, say the authors, will not only allow the Government to protect patients and the NHS but also boost investment in the life sciences sector by fostering trust and accountability.

Kath Sansom, Founder of Sling The Mesh, said:

‘The recent landmark inquiry into patient safety – First Do No Harm – encouraged the government to listen to the patients. It is vital that evidence-based action is taken to address conflicts of interest as these industry payments can lead to the publication of scientific literature which overstates benefits and downplays risks. It can also lead to treatment bias where a particular treatment is heavily pushed over others. We saw these things in the mesh scandal. It is vital we have a tool to prove and measure the impact of conflicts of interest in medicine. The available evidence points to legislation establishing a Sunshine-style database, which would serve as an authoritative, government-run transparency system and be a major step towards protecting patients.’