Editorial BMJ: American Med. Assn lobbying costs $16.5m

But in the ensuing days the BMJ published this data briefing looking at federal lobbying costs (doi:10.1136/bmj.f7366), and it portrays a scene in which doctors are far from absent. The single biggest spend on lobbying by a drug company in 2012 was Eli Lilly and Co’s $11.1m ({euro}8.1m, £6.8m). This was closely followed by Pfizer Inc at $10.2m and Merck and Co at $9.5m. But none even comes close to the $16.5m spent by the American Medical Association on influencing government to the benefit, often financial, of its members. And although it is by far the biggest spender of the professional representative organizations, the American Colleges of Radiology, Emergency Physicians, and Cardiology all counted their lobbying spends in millions of dollars in 2012, and are far from alone in doing so. There’s no doubt that self-interested lobbying represents a challenge in the battle against rising costs in US healthcare. What is less clear is whether doctors are part of the problem or the solution, and what they are willing to do to change the status quo. Cite this as: BMJ 2014;348:g135 Follow BMJ Editor Fiona Godlee on Twitter @fgodlee and the BMJ @bmj_latest