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April 10, 2017; The Intercept

The relationships between patient advocacy groups and big pharmaceutical companies have received a great deal of scrutiny lately. Up for question is the independence of the patient advocacy groups and the degree to which their priorities reflect the needs of patients vs. the best interests of corporations. These two sets of needs are often not in sync, but you might swear that they were when watching some of the interconnected activities.

The reach of drug companies into advocacy nonprofits extends beyond patient groups, too. The Intercept reports that this past week, as U.S. Sen. Franken’s (D-MN) Improving Access to Affordable Prescription Drugs Act gained steam, “independent” advocacy groups have placed an overwhelming number of advertisements in Beltway papers and news sites, including the Washington Post, Washington Times, Roll Call, The Hill, and Politico. The ads caution that recent proposals aimed at lowering the prices of prescription medications would have disastrous effects for patients and healthcare.

The Intercept points to the American Conservative Union (ACU), which describes itself as promoting “liberty, personal responsibility, traditional values, and strong national defense.” The full-page ad this organization placed asks, “Will government price setting lower the cost of her prescription drugs? Will government rationing increase his access to new, life-saving medicines?” Accompanying the message is a depiction of group of confused older folk.

Two advertisements come from Americans for Tax Reform (ATR), which warns against any attempt to interfere with “Part D’s protection against government interference in prescription drug pricing” and calls for retention of “free-market elements of the Medicare system.”

Keep Government Bureaucrats Out of Medicare Part D!” it heralds, not mentioning that it is funded by a nonprofit advocacy group whose financial interests are protected by the ban and, in fact, helped draft the ban.

Both nonprofits are sponsored by PhRMA, the Pharmaceutical Research and Manufacturers of America, which represents an industry group comprising Merck, Pfizer, Bristol-Myers Squibb, Purdue Pharma, and Eli Lilly. Based on review of PhRMA’s Form 990 filings, the Intercept reports that ATR received $746,000 from PhRMA between 2010 and 2014. And during the same period, ACU received $100,000.

ATR was founded by Grover Norquist, a former corporate lobbyist with a long history of using his nonprofit group to advance the interests of donors. In 2006, a congressional report found that lobbyist Jack Abramoff coordinated closely with Norquist to arrange special policy favors for his clients. In one email, Norquist requested a $50,000 donation to ATR in exchange for his group moving to oppose taxes on Brown-Forman products. The report further found that Abramoff arranged opinion columns authored by Norquist in support of Abramoff’s client goals in exchange for cash.

While there’s nothing new about coordination and collaboration between nonprofit advocacy groups seeking to influence public debate on a wide range of topics, the relationships between PhRMA and groups like ATR and ACU remind us that it’s important to know who is financing an advocacy campaign as well as who is promoting that campaign. Knowing who the players are is especially important when collaboration and cooperation between the players involves direct cash support, as cash increases the potential that a sale may have taken place.—Ruth McCambridge and Michael Wyland