Objectives To map specialty-specific industry payments to Australian healthcare professionals over a nine year period (2015–24), quantify distribution and concentration of payments, and compare patterns with those reported internationally.

Design Repeated cross-sectional and cohort analysis

Setting All public disclosures of payments by pharmaceutical companies to Australian healthcare professionals, 1 October 2015 to 31 October 2024.

Participants 23,528 named healthcare professionals who received at least one payment from a Medicines Australia member company.

Main outcome measures Primary outcomes were: (1) payment volume (number and value of payments, distribution by purpose of payment); (2) profession and specialty reach (proportion of registered practitioners with ≥ 1 payment; and (3) concentration of payments (the share of the total value received by top 1%, 5%, and 10% of recipients). Secondary outcomes were persistence of payments across reporting periods, breadth of company relationships, and company-specialty payment patterns.

Results 104,663 payments with a total value of A$164,445,101 (£79.0m) were reported. Payments ranged from A$1 to A$114,400, with a median of A$1,000 (IQR A$582 to A$1,600). Over 80% of paid clinicians received at least one payment for attending an educational meeting and over 90% of the total value of funding covered travel or fees for service. Medical practitioners accounted for A$148.7m (90.4% of total spending); nurses received A$11.7m (7.1%), and pharmacists A$1.8m (1.1%). In total, 12.2% of doctors, 2.1% of pharmacists, and 1% of nurses in Australia received at least one payment between 2015 and 2024. Specialist reach was highest in clinical haematology and oncology (86%) and rheumatology (82%). Payments were highly concentrated: the top 1% of clinicians received 25% of all dollars, the top 5% 55.3%, and the top 10% 70.5%. Persistence of payments was common, with 30.3% of clinicians appearing in more than two reporting periods. Annual totals peaked in 2016/17 (A$30.8m), contracted between 2018/19 to 2021/22 and rebounded by 2023/24 (A$21.6m).

Conclusion Pharmaceutical company payments to Australian healthcare professionals were common and highly concentrated, particularly in specialties with current on-patent medicines, mirroring patterns reported in the United States. Competing interests management should prioritise independence in clinician education, avoid company sponsored drug promotion, and maintain robust disclosure and governance.

What is already known Industry payments to clinicians are common internationally and can influence prescribing. Australian evidence to date has been fragmented by period, profession, or specialty.

What this study adds Using all named disclosures from 2015–24, payments in Australia were widespread, with over 1 in 10 doctors in Australia receiving at least one payment. Payments were also highly concentrated, with the top 1% of recipients receiving 25% of the total payment amount. Haematology and oncology and rheumatology had the highest specialty reach. Findings support stronger competing interests management in medical education and continuing professional development.

The authors have declared no competing interest.

This study did not receive any funding.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The University of Sydney Human Research Ethics Committee determined the study to be exempt from review because it used publicly available data.

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All data produced in the present study are available upon reasonable request to the authors.