Trust
Why is faith in the system eroding?
Drug and device makers routed $13.18 billion to physicians and teaching hospitals in 2024 and spent billions more advertising to patients, while breaches exposed nearly 290 million people's records and tested false health claims reached tens of millions. The money flows up as trust flows down.
Industry payments to clinicians and teaching hospitals, 2018 to 2024
Total of general, research, and ownership payments reported to CMS Open Payments each program year.
Read it this way The line climbs in nearly every year, from $11.07 billion in 2018 to $13.18 billion in 2024, so the story is sustained growth, not a one-year spike. It shows only the combined total. It does not show whether any single physician's payments influenced a specific prescription, which the sub-dashboard below breaks down.
⊞ data table⬇ CSV
| Year | Total payments (USD billions) |
|---|---|
| 2018 | 11.07 |
| 2019 | 11.98 |
| 2020 | 10.63 |
| 2021 | 12.64 |
| 2022 | 13.11 |
| 2023 | 13.14 |
| 2024 | 13.18 |
CMS, Open Payments FY2025 Report to Congress · 2018-2024 · source
Legislation in play that touches trust
- Mental Health Access and Provider Support Act of 2026
- Expanding Seniors Access to Mental Health Services Act
- Mental Health for Latinos Act of 2025
Counts from Congress.gov + state-legislation trackers, keyword-mapped to this Iron Triangle force. As of 2026-06-18. See the methodology note on the legislation dashboard.
Sources & methodology
- Report to Congress, FY2025 Annual Report on the Open Payments Program (CMS)
- Facts about Open Payments data (CMS)
- Industry Payments to US Physicians by Specialty and Product Type (JAMA)
- Association between industry payments and prescribing costly medications (BMC Health Services Research)
- Medicare Physician and Other Practitioners by Geography and Service, CY2022 (CMS)
- Dollars for Docs (ProPublica)
- KFF Health Misinformation Tracking Poll Pilot
- The Disinformation Dozen (Center for Countering Digital Hate)
- Measuring the impact of COVID-19 vaccine misinformation on vaccination intent (Nature Human Behaviour)
- Use of Alternative Medicine for Cancer and Its Impact on Survival (JNCI)
- Emergency Department Visits for Adverse Events Related to Dietary Supplements (NEJM)
- Breaches Affecting 500 or More Individuals (HHS OCR Breach Portal)
- Healthcare Data Breach Statistics, Updated for 2026 (The HIPAA Journal)
- 2025 Healthcare Data Breach Report (The HIPAA Journal)
- 2024 Healthcare Data Breach Report (The HIPAA Journal)
- 2022 Healthcare Data Breach Report (The HIPAA Journal)
- Medical Marketing in the United States, 1997 to 2016 (JAMA)
- Prescription Drugs: Medicare Spending on Drugs with DTC Advertising, GAO-21-380 (US GAO)
- The top 10 pharma drug brand ad spenders 2022 (Fierce Pharma, citing Vivvix / Kantar)
- Open Payments: Fiscal Year 2025 Report to Congress (CMS)
Per-chart citation straps carry the in-context detail; this is the full bibliography.