Healthcare lobbying and oncology.

5 Background: The healthcare industry spends more on lobbying than any other industry, with over $700 million spent in 2022. However, healthcare lobbying related specifically to cancer has not been characterized. In the current study, we analyze both overall health sector lobbying spending and oncology-related lobbying spending across both provider and patient organizations. Methods: We obtained lobbying data from OpenSecrets.org and the Federal Election Commission website. We categorized overall health sector lobbying spending as (1) Pharmaceuticals/Health Products, (2) Health Services/HMOs, (3) Hospitals/Nursing Homes, or (4) Health Professionals. We identified and categorized oncology-related lobbying organizations: (1) Oncology Physician Professional Organizations (OPOs, e.g., ASCO); (2) PPS-Exempt Cancer Hospitals; (3) Patient Advocacy Organizations; and (4) Provider Networks (e.g., US Oncology Network). We analyzed temporal trends in lobbying spending, in both overall dollar value (inflation-adjusted 2023 dollars) and in per-physician spending (using AAMC data for number of hematologists/oncologists). Significance was analyzed using a Mann-Kendall Trend Test. Results: Of overall health sector lobbying, Pharmaceuticals/Health Products had the greatest increase in lobbying spending from 2014 to 2022, with an increase from $294 million to $376 million (28%, p = 0.0006). In contrast, lobbying spending by health professionals did not change over this period, remaining at $96 million (p = 0.35). Regarding oncology-related lobbying, per-physician spending by OPOs and PPS-exempt cancer hospitals increased (Table). Overall, OPO lobbying has increased as a percentage of overall physician lobbying from 1.16% in 2014 to 3.76% in 2022 (not shown). Conclusions: While overall health sector lobbying spending by physicians/health professional lobbying has been relatively stable in recent years, lobbying spending by OPOs has increased. Continued efforts to understand the utility and value of lobbying in healthcare and across oncology are needed as the costs of care continue to rise. [Table: see text]