Cross-sectional analysis of financial relationships between board certified allergists and the pharmaceutical industry in Japan

BMC Med Ethics. 2024 Feb 20;25(1):22. doi: 10.1186/s12910-024-01014-2.

Abstract

Background: Financial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020.

Methods: A retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends were analyzed using generalized estimating equation models.

Results: Of the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 - $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 - 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic.

Conclusion: The majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic's onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan.

Keywords: Conflicts of interest; Ethics, Japan; Industry payments; Japanese Society of Allergology.

MeSH terms

  • Allergists*
  • Conflict of Interest
  • Cross-Sectional Studies
  • Disclosure
  • Drug Industry
  • Humans
  • Japan
  • Pandemics*
  • Pharmaceutical Preparations
  • Retrospective Studies

Substances

  • Pharmaceutical Preparations