Dive Brief:

• AdvaMed spent $79.4 million on lobbying from 1999 to 2018, making it the fifteenth biggest spender in the pharmaceutical and health product industry, according to a paper published Tuesday in JAMA Internal Medicine.

• Researchers identify the trade group as one of two organizations focused squarely on medtech in the top 20 spenders, the other being Medtronic. Device and drug product companies such as Abbott and Johnson & Johnson also feature in the list, but all trail far behind drugmaker trade group PhRMA in terms of dollars spent.

• The spending came during a period that included major industry efforts to repeal the 2.3% excise tax on medical devices, a part of the 2010 Affordable Care Act. The industry achieved that goal late last year.

Dive Insight:

The potential to influence policy led the pharmaceutical and health product industry to spend $4.7 billion on lobbying over the analyzed period at an average of $233 million per year. Spending peaked in 2009 to $318 million, the year leading up to passage of the ACA, the landmark law that came with major new levies and mandates on the all sectors of the industry.

While drugmakers and their trade groups accounted for most of the spending, medtech was also involved.

AdvaMed was the most active medtech lobbyist, followed by Medtronic, which spent $63.8 million over the analyzed period. The spending made Medtronic the seventeenth most active lobbyist in the analyzed sample.

J&J and Abbott spent more than either of the pureplay medtech groups, committing $129.9 million and $96.6 million respectively to their lobbying efforts. Baxter also made the top 20 by spending $58.4 million on lobbying.

The period analyzed in the JAMA paper ends before 2019, a key year for medtech lobbying. With the opportunity to repeal the medical device tax in sight, AdvaMed increased its spending last year. The trade group disclosed a single lobbying expense of $580,000 in the fourth quarter, well above its typical outlays of $50,000. Democratic House leader Nancy Pelosi is named in the disclosure.

AdvaMed’s lobbying push bore fruit late last year when President Donald Trump signed legislation to permanently repeal the medical device tax, which the industry had fought a rolling, years-long battle against since it was established as part of the ACA.

The JAMA paper also analyzes campaign contributions made by the pharmaceutical and health product industry. The top 20 campaign contributors among the wider industry reads like a who’s who of large pharma companies, with Pfizer, Amgen, Eli Lilly and GlaxoSmithKline occupying the top four spots. 

As the study authors see it, the spending data points to the need to discuss how to “temper the influence of industry on U.S. health policy.” That position is underpinned by a concern that the industry's financial firepower enables it to outspend groups that advocate changes that run counter to its interests.