The fact that the pharmaceutical industry has considerable financial influence on the medical profession is not a secret, although that reality deserves regular review.
AMA Revenue
An examination of American Medical Association revenue by Influence Watch states that only $34 million of the AMA’s $493 million 2022 total revenue came from membership dues. The lion’s share, $293 million, came from “royalties and credentialing products,” of which pharmaceutical companies are by far the largest purchasers. Other related income included $33.2 million in insurance commissions, $30.8 million in journal revenue and $13.3 million in advertising.1
MDs Are Getting Paid, Too
Drilling down to individual medical doctors, a review of data from the Open Payments platform from 2013-2022 found a total of $12.13 billion in payments to 826,313 medical providers. Of these payments, 93.8% were associated with one or more marketable medical products. The authors noted: “Despite evidence that financial conflicts of interest may influence physician prescribing and may damage patients’ trust in medical professionals, such relationships remain pervasive.”2
An article on the Healthcare Brew website estimates the actual amount to be much higher, reporting that drug and device companies paid $13.2 billion to medical professionals in 2024 alone, based on data released by the Centers for Medicare & Medicaid Services (CMS).3
Big Pharma and Medical Publishing
This past February, investigative journalist and five-time Emmy Award winner, Sharyl Attkisson, examined the impact of Big Pharma on medical publishing on her program, “Full Measure.” She opened the segment by stating:
“Some of the most prestigious medical journals in the world are the source of biased or even incorrect medical information at the highest levels. Information that’s distributed to our doctors and medical institutions, where it’s then used to mistreat and sometimes harm us.”
To substantiate her claims, Ms. Attkisson interviewed and referenced several prominent authorities, each one providing clarity regarding the current state of published medical research:
Joseph Varon, MD, FCCM, FCCP, president and chief medical officer of the Independent Medical Alliance, boldly stated: “There is no question that these journals have been taken hostage by Big Pharma. I mean, when you have journals that get more than 50% of their income from Big Pharma, you know that they’re going to publish things that’s favorable to these particular companies, so you lose credibility.”
Marcia Angell, MD, was made the interim editor-in-chief of The New England Journal of Medicine (NEJM) in 1999 before stepping down on June 30, 2000. A longtime member of the staff, she joined the NEJM in 1979, becoming the executive editor in 1988.
According to Dr. Angell, “Starting about then [the 1970s] was when you saw the drug companies assert more and more control, until finally over the next couple of decades, they began to treat the researchers as hired hands. They would design the research themselves. You know, you can do a lot of mischief in how you design a trial, or we’ll test this drug and we’ll tell you whether it can be published or not. And so if it’s a positive study, it’s published. If it’s a negative study, you never see the light of day. And so I became extremely distrustful of most of the research that was published. We often rejected things because it was clearly biased. But anything we rejected always ended up in another journal.”
The video segment quoted from a 2015 article by Richard Horton, MD, who has been the editor-in-chief of The Lancet since 1995. In the Lancet article, Dr. Horton explained: “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.”4
According to Ms. Attkisson’s findings, the journals utilize a number of different avenues to boost their Big Pharma revenue in addition to significant advertising dollars. The purchase of favorable study reprints can yield hundreds of thousands and sometimes even millions of dollars per article. Sponsored supplements, which critics say present industry content as science, also earn large amounts of money.
Perhaps the top source of additional revenue is the billions of dollars Big Pharma pays each year for open public access to select papers, resulting in an estimated $2.5 billion for six major publishers.
In addition to the above, there are multiple examples of omitted data, improprieties, undisclosed payments and other conflicts of interest, many of which, when discovered, ultimately caused papers to be retracted. This information begs the question: Can we trust “the science” as it relates to drugs?
Author’s Note: The “Full Measure” cover story is well worth the 11 minutes you’ll spend watching it: https://www.youtube.com/watch?v=ne9Lw9VQyYU. This is also a great link to share with your patients.
References
- American Medical Association (AMA). InfluenceWatch.org.
- Sayed A, Ross JS, Mandrola J, et al. Industry payments to US physicians by specialty and product type. JAMA, 2024;331(15):1325-1327.
- Catherman C. “Drug, Medical Device Industry Paid Physicians $13.2b in 2024.” Healthcare Brew, July 11, 2025.
- Horton H. “Offline: What Is Medicine’s 5 Sigma?” (comment) The Lancet, 2015;385(9976):1380.
