Thomas Vale follows money trails, lobbying networks, private foundations, and the financial machinery behind public policy.
We follow the money to see how lobbying, donations and data gaps shape what we know about drug harms and who pays to keep it quiet.
I investigate the cracks in adverse event reporting so readers can understand who benefits when harms go uncounted. Our team traces the money behind lobbying, donations and research contracts to map incentives that shape safety data. We use public registers and named reporting systems alongside investigative journalism to show how underreporting can be more than a technical problem. The goal is not to assert control but to show where financial links create pressure points that deserve scrutiny and urgent reform.
Why adverse event reporting matters
I start from a simple point. If adverse events are not reliably reported we do not have accurate safety signals. The FDA itself cautions that FAERS is a passive reporting system with limitations which can produce undercounts. We rely on that official admission and a landmark study by Lazarou et al in JAMA which estimated substantial morbidity and mortality from adverse drug reactions in hospitals. Those gaps matter when the firms that sell drugs also fund research and advocacy that shape what is measured.
Follow the money
When we follow the financial trail we see predictable patterns. Pharmaceutical companies spend hundreds of millions on lobbying and employ armies of consultants and lawyers to shape policy. OpenSecrets provides detailed lobbying records and shows the industry is one of the largest spenders in Washington. In the US the CMS Open Payments database documents millions paid from industry to clinicians. Those payments create incentives that can alter prescribing patterns and influence the culture of reporting. I credit OpenSecrets and CMS Open Payments for making this data public.
Funding flows to research and think tanks
Drug companies fund university research, patient groups and think tanks. Company annual reports and charity registers show multi million pound or dollar grants that support conferences and guideline writing. I have found corporate grant lists in company filings and in charity accounts that reveal repeat donors. Journalists such as Ben Goldacre have long campaigned for transparency through AllTrials and through reporting in The Guardian and the BMJ. Those investigations show that when data is controlled by sponsors, negative findings can be delayed or minimised.
The revolving door and contracting
There is also movement of personnel between regulators, industry and contract research organisations. Contracts and consultancy arrangements show how expertise becomes fungible. This creates both the potential for genuine collaboration and the danger of regulatory capture. We acknowledge that financial links suggest influence but do not prove control. Public registers and company filings are our sources for these observations.
What underreporting looks like in practice
Underreporting emerges as missing reports in FAERS, as unpublished trial data noted by researchers such as Peter Doshi in the BMJ, and as discrepancies between post marketing surveillance and real world signals. Investigative outlets such as ProPublica have documented cases where safety concerns were slower to reach the public than internal records suggested. Those accounts are important because they link documented events to decisions about transparency.
Small reforms could shift incentives
We emphasise practical fixes. Mandatory real time reporting, stronger conflict of interest registers, public access to all trial datasets and independent funding for safety surveillance would reduce the power of money to shape what is known. Our team draws on public records including company filings, charity registers, OpenSecrets and Open Payments to show the scope of the problem. We credit named journalists and academic studies where relevant and acknowledge that financial links point to pressure not proof of conspiracy.
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References and sources
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