{ "study": { "slug": "open-payments-research-concentration-2024", "title": "The $8.5 billion nobody counts: research is most of industry's money", "standfirst": "Every Open Payments study reads the same $3.31 billion general slice. But the largest kind of industry payment is research: $8.49 billion in 2024, 71% of all industry money on just 4.7% of records. And 98.9% of it goes to institutions, not individual physicians — paid out by a field one-third as broad.", "desk": "financial-distress", "article_type": "Original Research", "published": "2026-06-16", "issue": 79, "doi": "10.5072/fonteum/open-payments-research-concentration-2024", "url": "https://fonteum.com/research/open-payments-research-concentration-2024", "methodology_version": "open-payments/v1" }, "data_as_of": "2026-01-23", "datasets": [ { "slug": "cms-open-payments", "name": "CMS Open Payments", "publisher": "CMS — Open Payments", "upstream_url": null } ], "key_findings": [ { "number": "71.0%", "finding": "of all 2024 industry money disclosed under the Sunshine Act — $8.49 billion of $11.96 billion — is research payments, made on just 4.7% of the records. The five other Fonteum Open Payments studies, and most public coverage, analyze only the $3.31 billion general slice", "dataset": "cms-open-payments" }, { "number": "98.9%", "finding": "of research dollars — $8.40 billion — flow to research institutions and teaching hospitals, not to individual clinicians. Only $92.3 million (1.1%) reaches a named physician or non-physician practitioner. General payments are the mirror image: an individual flow", "dataset": "cms-open-payments" }, { "number": "$11,222", "finding": "average research payment — 52 times the $215 average general payment. The two files describe the same statute and barely overlap: research is a small number of very large institutional transfers, general is a vast number of small individual ones", "dataset": "cms-open-payments" }, { "number": "56.0%", "finding": "of every research dollar comes from just the top 10 of 683 reporting funders (top 25: 74.8%). The general-payment field is far broader — 1,763 funders, top 10 only 32.4% — so research money concentrates among roughly a third as many companies, and far more tightly", "dataset": "cms-open-payments" }, { "number": "$8.49B", "finding": "across 756,906 research records in the PY2024 release published 2026-01-23 (16,146,544 records in total). Every figure is a count or sum over published records — no individual physician, institution, or company is named, ranked, or scored", "dataset": "cms-open-payments" } ], "faqs": [ { "q": "What is a research payment in Open Payments?", "a": "It is a payment a drug or device company discloses as made in connection with a research study or clinical trial — the funding behind a trial, paid to the site, institution, or principal investigator conducting it. It is one of the three record types CMS publishes under the Sunshine Act, alongside general payments (meals, travel, consulting, royalties) and ownership or investment interests." }, { "q": "Why is research the biggest category if nobody talks about it?", "a": "Because it is institutional and lumpy rather than personal. Research payments were $8.49 billion in 2024 — 71.0% of all industry money — but on only 4.7% of the records, and 98.9% of the dollars went to research entities and teaching hospitals rather than to individual physicians. Coverage of Open Payments almost always reads the general-payment file, which is the story of money to named doctors; the research file is a story about institutions, and it is rarely opened." }, { "q": "Who actually receives research money?", "a": "Institutions. In 2024, $6.73 billion (79.2%) went to non-covered entities — research sites, clinics, and organizations that are not themselves Open Payments 'covered recipients' — and $1.67 billion (19.7%) to teaching hospitals. Only $92.3 million, 1.1% of the total, reached an individual physician or non-physician practitioner. The average research payment was $11,222, fifty-two times the $215 average general payment." }, { "q": "How concentrated is research funding?", "a": "Far more than general payments. Of 683 companies reporting research payments in 2024, the top 10 accounted for 56.0% of all research dollars and the top 25 for 74.8%. The general-payment field is much broader — 1,763 funders, with the top 10 holding only 32.4%. Research money comes from roughly a third as many companies and concentrates much more tightly among them." }, { "q": "Which companies fund the most disclosed research?", "a": "By 2024 dollars: ModernaTX ($662.8M, 7.8%), Novartis ($654.0M), Eli Lilly ($642.0M), Pfizer ($626.2M), Merck ($498.2M) and AbbVie ($428.4M). Vaccine and metabolic-drug makers lead — a different ladder from the general-payment ranking, where device royalties dominate. The figures describe disclosed research spending, not any judgment of the companies or the studies." }, { "q": "Does a large research payment imply anything improper?", "a": "No. A research payment is a disclosure of industry funding for a study, reported by the company. It is unrelated to fraud, exclusion, or any assessment of a clinician, institution, or company. This study draws no inference of wrongdoing from any payment; it only describes where the disclosed dollars sit." }, { "q": "Can I reproduce these figures?", "a": "Yes. Every number is a direct count or sum over the public cms_open_payments table for program year 2024 — the CMS Open Payments PY2024 release published 2026-01-23 — with no modeling. The exact SQL for the record-type split, the recipient-type breakdown, the funder concentration, and the research-versus-general contrast is published in the reproducibility block below. No individual is named." } ], "citation": { "apa": "Fonteum Research. (2026, June 16). The $8.5 billion nobody counts: research is most of industry's money. Fonteum Research, Issue 79. https://doi.org/10.5072/fonteum/open-payments-research-concentration-2024", "url": "https://fonteum.com/research/open-payments-research-concentration-2024" }, "reproducible_sql": "-- The $8.5 billion nobody counts — RESEARCH payments are the largest slice of\n-- industry money in Open Payments, yet every prior analysis reads only the\n-- general slice. Fully reproducible query.\n--\n-- Question: of the three kinds of payment the Sunshine Act discloses — general,\n-- research, and ownership — where do the dollars actually sit, who receives\n-- them, and how concentrated is the field that funds them? The lead figure:\n-- research payments are $8.49 billion, 71.0% of all 2024 industry money, from\n-- only 4.7% of the records — and 98.9% of those dollars go to research\n-- institutions and teaching hospitals, not to individual physicians. These are\n-- disclosure aggregates, NOT a quality, fraud, or wrongdoing signal of any kind.\n-- No individual is named, ranked, or scored.\n--\n-- Source:\n-- public.cms_open_payments — CMS Open Payments program-year-2024 release\n-- (PGYR2024, published 2026-01-23 via openpaymentsdata.cms.gov). Public,\n-- read-only. 16,146,544 records for program year 2024. License:\n-- US-Government-Works (17 U.S.C. Sec. 105).\n-- methodology_version = 'open-payments/v1'.\n--\n-- Universe: program year 2024, all three record types. \"Research\" = record_type\n-- 'research'; \"general\" = record_type 'general'; \"ownership\" = record_type\n-- 'ownership'. Figures are exact counts and sums over the published file, not\n-- modeled. CMS publishes annually and restates prior years.\n\n-- ============================================================================\n-- (1) Universe — the three kinds of payment side by side. Research holds 71.0%\n-- of the dollars on 4.7% of the records; its average payment is $11,222,\n-- 52x the $215 average general payment.\n-- ============================================================================\nWITH t AS (\n SELECT sum(total_amount_usd) AS all_usd, count(*) AS all_rec\n FROM public.cms_open_payments WHERE program_year = 2024\n)\nSELECT\n record_type,\n count(*) AS records,\n round(sum(total_amount_usd)) AS total_usd,\n round(100.0 * sum(total_amount_usd) / (SELECT all_usd FROM t), 1) AS pct_dollars,\n round(100.0 * count(*) / (SELECT all_rec FROM t), 1) AS pct_records,\n round(sum(total_amount_usd) / count(*)) AS avg_payment\nFROM public.cms_open_payments\nWHERE program_year = 2024\nGROUP BY record_type\nORDER BY total_usd DESC;\n-- research 756,906 $8,494,017,206 71.0% 4.7% $11,222\n-- general 15,385,047 $3,313,801,737 27.7% 95.3% $215\n-- ownership 4,591 $147,781,836 1.2% 0.0% $32,189\n-- (all three together = $11,955,600,779 across 16,146,544 records.)\n\n-- ============================================================================\n-- (2) WHO receives research money — by recipient type. 98.9% of research\n-- dollars go to NON-covered entities (research sites, clinics, and other\n-- organizations that are not themselves Open Payments \"covered recipients\")\n-- and to teaching hospitals; only 1.1% reaches an individual physician or\n-- non-physician practitioner. Research is an institutional money flow.\n-- ============================================================================\nSELECT\n recipient_type,\n count(*) AS records,\n round(sum(total_amount_usd)) AS total_usd,\n round(100.0 * sum(total_amount_usd)\n / sum(sum(total_amount_usd)) OVER (), 1) AS pct_of_research\nFROM public.cms_open_payments\nWHERE program_year = 2024 AND record_type = 'research'\nGROUP BY recipient_type\nORDER BY total_usd DESC;\n-- Non-covered Recipient Entity $6,727,235,867 79.2%\n-- Covered Recipient Teaching Hospital $1,674,441,900 19.7%\n-- Covered Recipient Physician $91,476,016 1.1%\n-- Covered Recipient Non-Physician Pract. $713,451 0.0%\n-- Non-covered Recipient Individual $149,972 0.0%\n-- institutions (entity + teaching hospital) = $8,401,677,767 = 98.91%\n-- individuals (physician + NPP + individual) = $92,339,439 = 1.09%\n\n-- ============================================================================\n-- (3) HOW CONCENTRATED the funders are. 683 manufacturers report research\n-- payments; the top 10 account for 56.0% of every research dollar, the top\n-- 25 for 74.8%, the top 50 for 85.0%. The single largest (ModernaTX) is\n-- 7.8% on its own.\n-- ============================================================================\nWITH m AS (\n SELECT manufacturer_name, sum(total_amount_usd) AS usd\n FROM public.cms_open_payments\n WHERE program_year = 2024 AND record_type = 'research'\n GROUP BY manufacturer_name\n),\ntot AS (SELECT sum(usd) AS t, count(*) AS n FROM m),\nranked AS (SELECT usd, row_number() OVER (ORDER BY usd DESC) AS rk FROM m)\nSELECT\n (SELECT n FROM tot) AS distinct_funders,\n round((SELECT t FROM tot)) AS research_usd,\n round(100.0 * sum(usd) FILTER (WHERE rk = 1) / (SELECT t FROM tot), 1) AS top1_pct,\n round(100.0 * sum(usd) FILTER (WHERE rk <= 10) / (SELECT t FROM tot), 1) AS top10_pct,\n round(100.0 * sum(usd) FILTER (WHERE rk <= 25) / (SELECT t FROM tot), 1) AS top25_pct,\n round(100.0 * sum(usd) FILTER (WHERE rk <= 50) / (SELECT t FROM tot), 1) AS top50_pct\nFROM ranked;\n-- distinct_funders 683 · research_usd $8,494,017,206\n-- top1 7.8% · top10 56.0% · top25 74.8% · top50 85.0%\n\n-- ============================================================================\n-- (4) The largest funders of disclosed research, top 12 by dollars. Vaccine and\n-- metabolic-drug makers lead — a different ladder from the general-payment\n-- ranking, where device royalties dominate.\n-- ============================================================================\nSELECT\n manufacturer_name,\n count(*) AS records,\n round(sum(total_amount_usd)) AS total_usd,\n round(100.0 * sum(total_amount_usd)\n / sum(sum(total_amount_usd)) OVER (), 1) AS pct_of_research\nFROM public.cms_open_payments\nWHERE program_year = 2024 AND record_type = 'research'\nGROUP BY manufacturer_name\nORDER BY total_usd DESC\nLIMIT 12;\n-- ModernaTX, Inc. $662,825,760 7.8%\n-- Novartis Pharmaceuticals Corporation $654,033,055 7.7%\n-- Eli Lilly and Company $642,014,681 7.6%\n-- PFIZER INC. $626,184,002 7.4%\n-- Merck Sharp & Dohme LLC $498,210,528 5.9%\n-- ABBVIE INC. $428,434,576 5.0%\n-- AstraZeneca Pharmaceuticals LP $345,584,468 4.1%\n-- Genentech, Inc. $341,045,829 4.0%\n-- Janssen Research & Development, LLC $340,333,107 4.0%\n-- E.R. Squibb & Sons, L.L.C. $217,975,186 2.6%\n-- GlaxoSmithKline, LLC. $210,445,131 2.5%\n-- Amgen Inc. $196,729,122 2.3%\n\n-- ============================================================================\n-- (5) CONTRAST — funder concentration, research vs general. The same query over\n-- general payments shows a far broader field: 1,763 funders, top 10 = 32.4%,\n-- top 25 = 52.3%. Research dollars concentrate among roughly a third as many\n-- funders, and far more tightly.\n-- ============================================================================\nWITH m AS (\n SELECT record_type, manufacturer_name, sum(total_amount_usd) AS usd\n FROM public.cms_open_payments\n WHERE program_year = 2024 AND record_type IN ('research','general')\n GROUP BY record_type, manufacturer_name\n),\nranked AS (\n SELECT record_type, usd,\n row_number() OVER (PARTITION BY record_type ORDER BY usd DESC) AS rk,\n sum(usd) OVER (PARTITION BY record_type) AS grp_total\n FROM m\n)\nSELECT\n record_type,\n count(*) AS distinct_funders,\n round(100.0 * sum(usd) FILTER (WHERE rk <= 10) / max(grp_total), 1) AS top10_pct,\n round(100.0 * sum(usd) FILTER (WHERE rk <= 25) / max(grp_total), 1) AS top25_pct\nFROM ranked\nGROUP BY record_type\nORDER BY record_type;\n-- general 1,763 funders · top10 32.4% · top25 52.3%\n-- research 683 funders · top10 56.0% · top25 74.8%", "license": "U.S. Government Works (federal sources; 17 U.S.C. §105)", "generated_by": "Fonteum — https://fonteum.com", "notes": "Aggregate, source-traced figures frozen to the snapshot above. Reproduce by running reproducible_sql against the cited federal dataset; no per-entity records are included." }