摘要：Health advocacy organizations (HAOs) are influential stakeholders in health policy. Although their advocacy tends to closely correspond with the pharmaceutical industry's marketing aims, the financial relationships between HAOs and the pharmaceutical industry have rarely been analyzed. We used Eli Lilly and Company's grant registry to examine its grant-giving policies. We also examined HAO Web sites to determine their grant-disclosure patterns. Only 25% of HAOs that received Lilly grants acknowledged Lilly's contributions on their Web sites, and only 10% acknowledged Lilly as a grant event sponsor. No HAO disclosed the exact amount of a Lilly grant. As highly trusted organizations, HAOs should disclose all corporate grants, including the purpose and the amount. Absent this disclosure, legislators, regulators, and the public cannot evaluate possible conflicts of interest or biases in HAO advocacy. HEALTH ADVOCACY ORGANI zations (HAOs) are among the most influential and trusted stakeholders in US health policy, pursuing an agenda that includes expanding government support for medical research and the availability of health care services. In addition, HAOs advocate for members' unrestricted access to all drugs, devices, and diagnostic tools relevant to their health conditions, almost always favoring branded drugs over generics, new screening technologies over older ones, and open formularies rather than closed ones. These positions closely correspond to the marketing aims of pharmaceutical and device companies; each position would help to increase product sales. Yet, despite the overlapping interests of HAOs and the pharmaceutical industry, the financial relationships between them have remained relatively unexplored. We conducted the current study in an effort to fill this knowledge gap. This investigation is feasible because data on industry contributions to HAOs have recently become publicly available, which allows for an examination of HAOs' disclosure practices. In response to US Department of Justice criminal prosecutions and state legislative mandates, some drug and device companies now report on their Web sites the precise dollar amounts of the grants and gifts they make to HAOs. Thus, it is now possible to analyze which HAOs the industry selects for funding and the HAOs' degrees of transparency in reporting that funding. We selected Eli Lilly and Company for analysis because it was the first company to make its grant registry public. The Lilly registry identifies the HAOs receiving support and the exact level of support each HAO receives. Lilly's registry provides specific information about the company's grant-giving policies and practices; this information is made even more useful when supplemented by Lilly's financial reports on its best-selling drugs. On the other side of the grant equation, it would be reasonable to expect HAOs to be fully transparent about their grantors, given the credibility that HAOs enjoy. An examination of the Web sites of the HAOs that received funding from Lilly makes it possible to determine the degree to which each HAO has disclosed its Lilly funding.
