Nature and Trends in Personal Payments Made to the Respiratory Physicians by Pharmaceutical Companies in Japan between 2016 and 2019

Anju Murayama; Momoko Hoshi; Hiroaki Saito; Sae Kamamoto; Manato Tanaka; Moe Kawashima; Hanano Mamada; Eiji Kusumi; Binaya Sapkota; Sunil Shrestha; Rajeev Shrestha; Divya Bhandari; Toyoaki Sawano; Erika Yamashita; Tetsuya Tanimoto; Akihiko Ozaki

doi:10.1159/000526576

Nature and Trends in Personal Payments Made to the Respiratory Physicians by Pharmaceutical Companies in Japan between 2016 and 2019

Respiration. 2022;101(12):1088-1098. doi: 10.1159/000526576. Epub 2022 Nov 9.

Authors

Anju Murayama^{1

2}, Momoko Hoshi^{1

3}, Hiroaki Saito⁴, Sae Kamamoto¹, Manato Tanaka¹, Moe Kawashima^{1

5}, Hanano Mamada¹, Eiji Kusumi⁶, Binaya Sapkota⁷, Sunil Shrestha⁸, Rajeev Shrestha⁹, Divya Bhandari¹, Toyoaki Sawano¹⁰, Erika Yamashita¹, Tetsuya Tanimoto¹¹, Akihiko Ozaki^{1

12}

Affiliations

¹ Medical Governance Research Institute, Tokyo, Japan.
² Tohoku University School of Medicine, Sendai, Japan.
³ Department of Public Health Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan.
⁴ Department of Gastroenterology, Sendai Kosei Hospital, Sendai, Japan.
⁵ School of Medicine, Fukushima Medical University, Fukushima, Japan.
⁶ Department of Internal Medicine, Navitas Clinic Shinjuku, Tokyo, Japan.
⁷ Nobel College Faculty of Health Sciences, Affiliated to Pokhara University, Kathmandu, Nepal.
⁸ School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia.
⁹ Department of Pharmacy, District Hospital Lamjung, Besisahar, Nepal.
¹⁰ Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan.
¹¹ Department of Internal Medicine, Navitas Clinic, Tachikawa, Japan.
¹² Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan.

Abstract

Background: Financial relationships between healthcare professionals and pharmaceutical companies have historically caused conflicts of interest and unduly influenced patient care. However, little was known about such relationship and its effect in clinical practice among specialists in respiratory medicine.

Methods: Based on the retrospective analysis of payment data made available by all 92 pharmaceutical companies in Japan, this study evaluated the magnitude and trend of financial relationships between all board-certified Japanese respiratory specialists and pharmaceutical companies between 2016 and 2019. Magnitude and prevalence of payments for specialists were analyzed descriptively. The payment trends were assessed using the generalized estimating equations for the payment per specialist and the number of specialists with payments.

Results: Among all 7,114 respiratory specialists certified as of August 2021, 4,413 (62.0%) received a total of USD 53,547,391 and 74,195 counts from 72 (78.3%) pharmaceutical companies between 2016 and 2019. The median (interquartile range) 4-year combined payment values per specialist were USD 2,210 (USD 715-8,178). At maximum, one specialist received USD 495,332 personal payments over the 4 years. Both payments per specialist and number of specialists with payments significantly increased during the 4-year period, with 7.8% (95% CI: 5.5-9.8; p < 0.001) in payments and 1.5% (95% CI: 0.61-2.4; p = 0.001) in number of specialists with payments, respectively.

Conclusion: The majority of respiratory specialists had increasingly received more personal payments from pharmaceutical companies for the reimbursement of lecturing, consulting, and writing between 2016 and 2019. These increasing financial relationships with pharmaceutical companies might cause conflicts of interest among respiratory physicians.

Keywords: Conflict of interest; Ethics; Health policy; Industry payment; Japan; Japanese respiratory society; Physician payment; Respiratory specialist.

MeSH terms

Conflict of Interest*
Drug Industry*
Humans
Japan
Pharmaceutical Preparations
Pulmonologists
Retrospective Studies

Substances

Pharmaceutical Preparations

Grants and funding

This study was funded in part by the Medical Governance Research Institute. This nonprofit research organization received donations from a dispensing pharmacy, Ain Pharmacies, other organizations, and private individuals. This study also received support from Tansa, an independent nonprofit news organization dedicated to investigative journalism. None of the entities providing financial support for this study contributed to the design, execution, data analyses, interpretation of study findings, and manuscript drafting. There was no award/grant number for the financial support.