Health lobbying spending grew by more than 70 percent between 2000 and 2020, driven mainly by pharmaceutical and medical device manufacturers, and providers, according to an analysis published in JAMA Health Forum.
As a whole, the health industry spent $713.6 million in 2020, compared to $358.2 million in 2000. In 2020, manufacturers accounted for more than 40 percent of the total ($308.4 million), followed by providers ($286.9 million).
The analysis found spending was highly concentrated, with the top 10 percent of firms responsible for about 70 percent of spending among payers, 69 percent among manufacturers and 59 percent among providers.
Spending among other firms was less concentrated, with the top 10 percent responsible for almost 38 percent of spending.
The disproportionate level of spending could result in clear winners and losers, with the large groups that are able to spend more having an outsized influence on shaping policy.
The analysis also found that the steepest growth in spending occurred prior to 2010, as Congress and federal agencies were working to craft the legislation that would become the Affordable Care Act.