Objectives – To assess the relationship between UK-based patient organisation funding and companies’ commercial interests in rare and non-rare diseases in 2020.

Design – Retrospective analysis of the value and volume of payments from pharmaceutical companies to patient organisations in the UK matched with data on the conditions supported by patient organisations and drugs in companies’ approved portfolios and research and development pipelines.

Setting – UK.

Participants – 74 pharmaceutical companies making payments to 341 UK-based patient organisations.

Main outcome measures – Alignment between the commercial interests of pharmaceutical companies and the disease area focus of patient organisations; difference in the volume and value of payments to patient organisations broken down by prevalence of conditions; industry funding concentration, measured as the number of companies funding each patient organisations, the share of overall industry funding coming from each contributing company and the share of industry funding of each organisation comprised by the single highest payments.

Results – 1,422 payments were made by 74 companies to 341 patient organisations. Almost all funds (90%) from pharmaceutical companies were directed to patient organisations that are aligned with companies’ approved drug portfolios and research and development pipelines. Despite rare diseases affecting less than 5% of the UK population, more than 20% of all payments were directed to patient organisations which target such conditions. Patient organisations focusing on rare diseases relied on payments from fewer companies (p-value = 0.0031) compared to organisations focusing on non-rare diseases.

Conclusions – Companies predominantly funded patient organisations operating in therapeutic areas relevant to companies’ portfolio or drug development pipeline. Patient organisations focusing on rare diseases received more funding relative to the number of patients affected by these conditions and relied more heavily on payments from fewer companies compared to organisations targeting non-rare diseases. Increased independence of patient organisations could help avoiding conflicts of interest.