Emily Rickard is a PhD Candidate in the Department of Social and Policy Sciences at the University of Bath. Dr Piotr Ozieranski is a Senior Lecturer in the Department of Social and Policy Sciences at the University of Bath.
All-Party Parliamentary Groups (APPGs) are informal clusters of lawmakers that focus on particular issues and seek to influence government. They are unique and valuable forums for exchange of opinion; however, they face a crucial dilemma – should they accept funding from external donors given that they do not receive funding from Parliament?
Due to their informal and cross-party nature, APPGs may be of particular interest to pharmaceutical companies seeking to have a say in important early policy discussions regarding key areas of health policy such as drug pricing strategies and funding for cancer drugs.
Big pharma’s web of influence
To determine the extent of the pharmaceutical industry’s financial involvement with the 146 APPGs focused on health-related topics, we extracted details from 6,628 entries in the APPG Register and identified £7,283,415 worth of payments from external donors.
Amongst our key findings were that 16 APPGs received £1,211,346 from 35 pharmaceutical companies (typically big pharma companies) between 2012-2018. Two APPGs received more than half of this funding – the APPG for Health (£414,922) followed by the APPG for Cancer (£252,558).
We also revealed important insights into influence at the ‘infrastructural’ level, as the pharmaceutical industry prioritised the indirect provision of funding for secretariat support. Secretariats are situated at the heart of an APPG and are responsible for the day-to-day running, therefore industry involvement at this level may be particularly influential in terms of the direction and scope of topics discussed.
We also found evidence of the potential extent of the pharmaceutical’s web of influence, as 50 APPGs received 304 payments worth £986,055 from 57 patient organisations which themselves had coincidentally received a combined total of £27,883,556 from 65 drug companies. Most of the patient organisations were fulfilling the secretariat role, but questions remain as to whether this funding leads to these organisations representing the pharmaceutical industry.
Raising questions around independence of APPGs
The pharmaceutical industry’s extensive financial involvement in APPGs raises concerns around possible undue influence. The danger is that industry interests might be being prioritised above patients in early policy discussions, a critical stage where policymakers’ ideas are being crystallised, and where the effectiveness of lobbying is arguably the highest. Indeed, we also know that even small amounts of pharma funding can influence prescribing in doctors, therefore we need to question if APPGs know receiving industry funding might influence them and, if so, what they are doing to address this issue. A key mechanism at play is the obligation to reciprocate, something that needs to be explicitly considered in APPG guidelines to mitigate against undue influence.
Further, there is currently no way of ascertaining an APPG’s impact on the policymaking process, which extends the possibilities of corporate funding and its impact to go unnoticed on legislative outputs. Key issues and debates discussed in meetings and outputs need to be tracked or monitored so that the impact of an APPG can be measured. This would clarify the role of APPGs as well as allowing the influence of external funding to be determined and evidence whether funders’ interests are pursued. This tracking could be incorporated into the current Register requirements, with APPGs filling in a template document annually to help themselves, Parliament, funders, and the public to monitor their activity. Information captured could include details of an APPG’s activities, why they were carried out, and any impacts on legislation (which can be continually updated). This is particularly important given the potential for APPGs to be used by external parties to influence policy discussions. Ultimately, considering the important role APPGs play as forums for policy discussion, none of what they do needs to happen behind closed doors.
Transparency in name only
Our exploration of pharmaceutical industry payments revealed significant transparency issues related to the APPG Register. Whilst it is very important that these payments are currently disclosed, more needs to be done to improve practical transparency to help create a more user-friendly interface. We suggest some ways that this could be achieved.
Firstly, and perhaps most importantly, a centralised searchable database of payments to APPGs needs to be created, allowing interested citizens to check how much support each APPG receives, in what forms and from whom (including the sector they are part of). This could be part of transparency reforms which need to occur more broadly across Parliament to make all disclosed information accessible and analysable.
Secondly, all payments should have informative descriptions – currently hundreds of thousands of pounds are being provided by pharmaceutical companies for unknown purposes. Even the payments that do have descriptions provided are very brief, for example ‘event’, making it impossible to interpret potential impacts.
Thirdly, APPG guidance needs to be updated so that all payments are disclosed - a key issue with current guidelines means that money may be entering the APPG bloodstream undisclosed as payments are only reported if the value exceeds £1,500 in a year.
Fourthly, the formal APPG Register needs to be broadened as it does not currently capture everything, for example conflicts of interests of patient organisations which have received money from pharma. All potential conflicts of interests should be reported in one place.
Need for a bigger rethink?
Ultimately, however, transparency is not a panacea because it cannot address imbalances of power between corporations and recipients of their payments. Therefore, the only way to ensure complete impartiality is either for Parliament to introduce its own internal funding of APPGs, or the creation of a ‘pool’ of corporate funding which APPGs can apply for with decisions made by an independent panel. With the former, it would cost the state relatively little to compensate the funding if corporate donations were to stop, and it would have the ultimate benefit of protecting the heart of democracy.
All articles posted on this blog give the views of the author(s), and not the position of the IPR, nor of the University of Bath.