Flu vaccine manufacturers contract the National Immunisation Lead for the Royal College of GPs.

In previous articles, we’ve briefly looked at data in the Disclosure UK database that related to ITVGate and an overview of payments from pharmaceutical companies to UK healthcare organisations such as King’s College London.

So we don’t have to keep covering the same ground, please read our two previous articles for an overview of Disclosure UK and the data it publishes.

In this article, we delve into payments from pharmaceutical companies to UK medical royal colleges.  As we noted in our previous articles, little detail is given about these payments but we know that these payments do not relate to research and development activities.

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In the United Kingdom, a medical royal college is a professional body responsible for the development of and training in one or more medical specialities. The Academy of Medical Royal Colleges is the coordinating body for the UK and Ireland’s 24 Medical Royal Colleges and Faculties.

For the three years 2020-2022, pharmaceutical companies paid Royal Colleges £3.7 million.  These payments are referred to as transfer of values (“ToVs”) as they include both monetary and non-monetary values paid or given to either healthcare organisations (“HCOs”) or healthcare professionals (“HCPs”).

The vast majority of ToVs to medical royal colleges, about 90% by value, are categorised as either:

• donations and grants; or

• sponsorship agreements with healthcare organisations (HCOs), or third-party organisations appointed by HCOs, to manage an event or meeting.

Making up the majority of the entire three-year total are payments to just two medical royal colleges: the Royal College of General Practitioners (£1,836,937) and the Royal College of Physicians (£1,262,810). Payments to these two institutions over the three years totalled £3.1 million, 83% of the total paid to UK medical royal colleges.

The Royal College of General Practitioners (“RCGP”) has over 54,000 members and is the largest of the medical royal colleges. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards.

According to RCGP’s financial statements for 2022, its total income was just under $39.8 million.  In 2021, its income was £36.5 million. Previous financial statements show an income of £43.4 million for 2020. Over the three years, pharmaceutical companies’ ToVs to RCGP represent 1.5% of its income.

The Royal College of Physicians (“RCP”) has over 40,000 members and fellows and is dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Its members work in hospitals and the community across more than 30 different medical specialities.

In the UK, a physician is a general term for someone who practices medicine. Usually, physicians have a specialist area.

The latest financial statements we could find on RCP’s website were for the year 2019.  In 2019, RCP showed a total income of £42,7 million which is not too dissimilar to RCGP.  If we assume RCP roughly earned the same as RCGP during the years 2020-2022, then ToVs for that period from pharmaceutical companies would represent in the region of 1% of RCP’s total income.

Is 1% of total income sufficient to influence an institution’s decisions? 

Considering ToVs to medical royal colleges consist mainly of donations, grants and sponsorships, it could be pharmaceutical companies have influenced these institutions’ decision-making in targeted areas. However, without further details about what the ToVs relate to, it’s not possible to deduce what influence these payments may or may not have had.

For both institutions, Pfizer paid the largest sum of all the pharmaceutical companies.  Over the three years, Pfizer paid the two Royal Colleges £934,600, 30% of the total £3.1 million.

Please note:  The name of the institution can vary between pharmaceutical companies.  We have standardised this as much as possible. Because of the variation in institution names, after preparing our lists we realised we had omitted ToVs to the “Faculty Of Sexual And Reproductive Healthcare Of The Royal College” which for the three years totalled £64,190 and “Beds & Herts Royal College of General Practitioners Faculty” which totalled £199.

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In addition to ToVs being made to medical royal colleges, i.e. the institutions, ToVs were also made to employees of these colleges.  These can be found by searching the Disclosure UK database under the category “HCP.”

The highest individual earner who works for a royal college is Dr. George Kassianos. 

On Disclosure UK he has two profiles.  One is listed as “Healthcare Admin Board Member” for “Royal Collage of GPs” and the other as “miscellaneous” for “not available.” 

We know it is the same person as Wokingham Today referred to him as “a Wokingham doctor” when announcing he had been awarded a Commander of the Order of the British Empire (“CBE”) in 2020.

Disclosure UK, Healthcare Professional (“HCP”) search

Aggregating his earnings from all pharmaceutical companies for the three years 2020 to 2022, Dr. Kassianos has been paid £167,597.  Apart from approximately £2,000, the payments were disclosed as for “contracted services.”

While 1% of the institution’s annual income may or may not be sufficient to buy influence, £40-£70,000 per year is certainly enough to significantly influence a person’s “expert” advice and opinions, as well as any influence that person can exert on an institution or national policy.

Dr. Kassianos is a renowned figure in the medical field, particularly in the areas of general practice, travel medicine and immunisation. He retired from general practice in 2017 after 38 years of service. 

He has held various prestigious positions, including being the RCGP’s National Immunisation Lead since 1996. He is also a member of the UK Health Security Agency (“UKHSA’s”) Public Health Advisory Panel on Healthcare Workers Infected with Blood-borne Viruses.

According to his biography on the British Global Health Association, of which he is president, he writes extensively in the medical press and is a member of the British Medical Journalists’ Association.

He is the associate editor of the international journal Drugs in Context; and, a member on the editorial boards of journals such as The British Journal of Cardiology, Geriatric Medicine, Primary Care Cardiovascular Journal, The British Journal of Family Medicine, the Bulgarian journal Preventive Medicine; and, is the GP editorial consultant for the journal Guidelines in Practice.

He is on the Faculty of Medscape and has participated in a number of educational projects and continues to do so. He has also lectured on cardiology and immunisation subjects abroad, in over 30 countries.

In 2020, he became a regular guest on BBC Radio Berkshire’s breakfast programme, answering questions about covid-19 from listeners and the show’s hosts.

What “contracted services” pharmaceutical companies paid him for is anybody’s guess.  Perhaps by looking at the two companies that paid the largest amounts to Dr. Kassianos – the National Immunisation Lead for the Royal College of General Practitioners and member of the British Medical Journalists’ Association – we could get an indication of what questions we could or should be asking.

Sanofi

French pharmaceutical company Sanofi is one of four vaccine manufacturers that supply the UK with influenza vaccines.  Sanofi supplies two flu vaccines: one indicated from the age of 6 months and the other from 18 years of age and older.  Both are injections.

Sanofi engages in the research and development, manufacturing and marketing of pharmacological products, principally in the prescription market, but the company also develops over-the-counter medications.

The corporation covers seven major therapeutic areas: cardiovascular, central nervous system, diabetes, internal medicine, oncology, thrombosis and vaccines against several diseases. Its website boasts that over 500 million people are vaccinated with Sanofi vaccines annually and 1.3 million doses of its vaccines are delivered every day.

For a full list of products that Sanofi markets in the UK see HERE.

Seqirus

Another of the four flu vaccine suppliers to the UK is Seqirus.

Seqirus has a singular focus on influenza and is one of the largest influenza vaccine companies globally. “Our vision is a world protected from influenza,” its website states. 

It is a subsidiary of the Australian biotechnology company CSL. Although, according to Seqirus’ website, it does not have an office in the UK, the company has a strong presence in the UK. 

Seqirus sells two flu vaccines to the UK: one that is indicated for babies and children from 6 months of age and the other for people aged 65 years and older. Both are injections. 

The Medicines and Healthcare products Regulatory Agency (“MHRA”) has given both Seqirus flu vaccines “Black Triangle” status.  The Black Triangle label denotes they are new drugs with relatively limited information about their safety from clinical trials. Because of limited safety information, they are being monitored under MHRA’s Black Triangle Scheme.

Influenza Vaccines Are Big Business

In September 2022, UKHSA issued a statement urging over 30 million people to take up  the “vital” flu and covid “vaccines.”  In 2022, the population of the UK was estimated to be 67.7 million people.  So, UKHSA was urging almost half of the UK population to get a flu vaccine. 

The age groups being targeted in the flu vaccine campaign were people aged over 65, all primary school children and some secondary school children. Children are usually given the flu nasal spray vaccine at school, UKHSA said.

Adding, “GP surgeries are also inviting children aged 2 and 3 years old (age on 31 August) for this nasal spray vaccination at their practices.”

AstraZeneca is the only vaccine manufacturer that supplies flu nasal spray vaccines for toddlers and children (See list of all influenza vaccines marketed in the UK for the 2024 to 2025 season HERE.) 

So, in respect of GPs vaccinating toddlers, UKHSA’s campaign benefitted AstraZeneca and not Sanofi or Seqirus.

However, a year later, in September 2023, UKHSA announced an advance purchase agreement with Seqirus to produce over 100 million influenza pandemic vaccines if or when they are needed.  No mention is made of whether the 100 million doses will be delivered over one year or five years, say.  But for an estimated population of 67.7 million, that’s a lot of flu vaccines.

“The vaccines will be tested, licensed, and approved and tailored to combat the specific pandemic flu strain identified at the time,” UKHSA said. “They will be produced at CSL Seqirus’s existing manufacturing plant in Liverpool in the event a pandemic is declared by the World Health Organisation (WHO).”

Seqirus is onto a good thing. And it raises the question: what ToVs have pharmaceutical companies made to UKHSA, formerly Public Health England, or are ToVs from pharmaceutical companies to the likes of Dr. Kassianos enough to buy the required influence?

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