Pharmaceutical payments to certified oncology specialists in Japan in 2016: a retrospective observational cross-sectional analysis

Abstract

ObjectiveThis study investigated payments made by pharmaceutical companies to oncology specialists in Japan, what the payments were for and whether the receipt of such payments contravened any conflict of interest (COI) regulations.Design, setting and participantsPayment data to physicians, as reported by all pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association, were retrospectively extracted for 2016. Of the named individual recipients of payments, all certified oncologists were identified, using certification data from the Japanese Society of Medical Oncology (JSMO). The individual specialisations of each of the oncologists was also identified.OutcomePayments to individual cancer specialists and what they were for were identified. Factors associated with receipt of higher value payments and payment flows to specialties were determined. Companies selling oncology drugs with annual sales of ≥5 billion yen (£33.9 million, €40.2 million and $46.0 million) (high revenue-generating drugs) were identified.ResultsIn total, 59 companies made at least one payment to oncologists. Of the 1080 oncology specialists identified, 763 (70.6%) received at least one payment, while 317 received no payment. Of the 763, some 142 (13.1%) receiving at least 1 million yen (£6,800, €8,000 and $9200) accounted for 71.5% of the total. After adjustment of covariates, working for university hospitals and cancer hospitals and male gender were key factors associated with larger monetary payments. Payments preferentially targeted on cancer specialties using high revenue-generating drugs. The JSMO has its own COI policy for its members, but the policy did not mention any specific guidelines for certified oncology specialists.ConclusionFinancial relationships were identified and quantified between pharmaceutical companies and oncology specialists, but the extent and worth varied significantly. Given the frequency and amounts of money involved in such linkages, it would be beneficial for specific COI regulations to be developed and policed for oncologists.

Pharmaceutical company payments to dermatology Clinical Practice Guideline authors in Japan

“…Kathyrn et al reported Pharma tended to make more payments to male physicians than to female ones in the US [16,17]. Further, in Japan, similar findings were observed in the case of certified oncologists [13], and our findings were consistent with the previous studies. Although there are 1.25 times more male dermatologists than female dermatologists (3189 male dermatologists and 2543 female dermatologist) in Japan [18], the lower proportion of female CPG authors and lower Pharma payments to female CPG authors could not be explained merely by the discrepancy in numbers alone.…”

“…Universities and professors traditionally have been regarded as a symbol of authority in Japan. As repeatedly suggested in our previous works, university professors have a strong influence on practices and treatments in their clinical fields, and other physicians tend to follow a professors' decision of suitable treatment without question or criticism [13]. This result supports the idea that Pharma may be targeting and making payments to senior physicians who can influence of set clinical practice.…”

“…Payment data were published on the website of each company which was, at the time, a member of the Japan Pharmaceutical Manufacturing Association (JPMA). We collected the payment data from the 78 and 73 companies (79 companies in total) which belonged to the JPMA in 2016 and in 2017, respectively, as in our previous study [13].…”

Pharmaceutical Company Payments to Japanese Government Drug Regulation Committee Members

“…result, their commercial products will generate a greater income and help maximize their profits. 6,[8][9][10] In most countries, pharmaceuticals are officially regulated by governmental authorities, such as the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). The staff of these regulatory authorities are usually prohibited from having financial dealings of any kind with pharmaceutical companies as a means of avoiding undesirable influence and possible corruption, especially as their roles and positions are quite public.…”

“…If this is not the case, public trust and faith in medicine and the nation's health system will be further eroded 6,7 . However, previous studies have repeatedly shown that pharmaceutical companies often make payments to highly influential specialists, such as university professors and clinical practice guideline authors, presumably hoping that, as a result, their commercial products will generate a greater income and help maximize their profits 6,8‐10 …”