J Surg Res. 2025 Nov 07. pii: S0022-4804(25)00678-X. [Epub ahead of print]315 950-958
INTRODUCTION: Academic surgery departments (ASDs) advance education, research, and patient care. Corporate revenue pressures raise concerns about academic productivity. We analyzed trends in funding, publications, clinical trials, and ASD-affiliated healthcare system revenue to assess potential corporate influence on academic missions.
MATERIALS AND METHODS: We selected the top NIH-funded ASDs and sourced data from NIH RePORTER, Scopus, ClinicalTrials.gov, and CMS Open Payments Database. Healthcare system financial data were obtained from 501(c)(3) 990 IRS forms. Analysis covered 2008-2022, inflation-adjusted values. Trends were analyzed via linear regression. Geographic analyses covered U.S. census divisions.
RESULTS: In 2023, the top 50 U.S. ASDs secured $620,924,661 in NIH funding through 1134 active projects, constituting 92% of all NIH surgery department funding ($674,284,863). The top funded NIH activity codes were R ($377,022,199; 61%), U ($137,773,898; 22%), and P ($64,600,920; 10%). Between 2008 and 2022, overall NIH funding increased by an average of $10,222,070 annually, as did research output (+2821 documents/year) and surgery-related clinical trials (133 trials/year). Industry research funding remained stable (+$12,337,829 annually); however, nonresearch industry payments increased (+$102,765,144 annually). Revenue for healthcare systems exceeded $1.33 trillion, with a positive margin of $76.65 billion. All systems saw revenue growth, (β = +$7.79 billion annually), except two with losses (β = +$453,771,582 annually). The East North Central and Middle Atlantic divisions exhibited the most significant increases in both NIH funding (+$3,221,371 and +$2,584,457 annually, respectively) and revenue (+$1.67 billion and +$2.13 billion annually, respectively).
CONCLUSIONS: In the era of corporate medicine, major U.S. ASDs maintained NIH funding, research output, and revenue growth, particularly in the East North Central and Middle Atlantic divisions, with stable industry research funding and a rise in industry nonresearch payments.
Keywords: Academic surgery department; Corporate medicine; Healthcare system revenue; Industry payments; NIH funding; Research productivity