[Skip to Content]
[Skip to Content Landing]
Table.  Pharmaceutical Payments Made to Executive Board Members From 19 Professional Medical Associations in 2016, Japan
Pharmaceutical Payments Made to Executive Board Members From 19 Professional Medical Associations in 2016, Japan
1.
Rothman  DJ, McDonald  WJ, Berkowitz  CD,  et al.  Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest.  JAMA. 2009;301(13):1367-1372. doi:10.1001/jama.2009.407PubMedGoogle ScholarCrossref
2.
Fabbri  A, Gregoraci  G, Tedesco  D,  et al.  Conflict of interest between professional medical societies and industry: a cross-sectional study of Italian medical societies’ websites.  BMJ Open. 2016;6(6):e011124. doi:10.1136/bmjopen-2016-011124PubMedGoogle ScholarCrossref
3.
Tringale  KR, Marshall  D, Mackey  TK, Connor  M, Murphy  JD, Hattangadi-Gluth  JA.  Types and distribution of payments from industry to physicians in 2015.  JAMA. 2017;317(17):1774-1784. doi:10.1001/jama.2017.3091PubMedGoogle ScholarCrossref
4.
Japan Pharmaceutical Manufacturers Association. Data book 2018 [in Japanese]. http://www.jpma.or.jp/about/issue/gratis/databook/2018/. Published 2018. Accessed October 2, 2018.
5.
Japan Pharmaceutical Manufacturers Association. Transparency guideline for the relation between corporate activities and medical institutions [in Japanese]. http://www.jpma.or.jp/english/policies_guidelines/transparency_guideline.html. Published 2018. Accessed July 15, 2018.
6.
Centers for Medicate & Medicaid Services. Open Payments homepage. https://openpaymentsdata.cms.gov/. Accessed December 12, 2018.
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    Research Letter
    Health Care Policy and Law
    February 4, 2019

    Pharmaceutical Company Payments to Executive Board Members of Professional Medical Associations in Japan

    Author Affiliations
    • 1Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan
    • 2Medical Governance Research Institute, Minato-ku, Tokyo, Japan
    • 3Department of Anesthesiology, Jichi Medical University Saitama Medical Center, Saitama, Saitama, Japan
    • 4Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
    • 5Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo, Japan
    JAMA Intern Med. 2019;179(4):578-580. doi:10.1001/jamainternmed.2018.7283

    Physicians often receive payments from pharmaceutical companies for purposes that include speaking and consulting.1-3 The Japan Pharmaceutical Manufacturers Association includes most companies that manufacture brand name drugs. In 2015, its members accounted for 80.8% of total pharmaceutical sales in Japan.4 In 2011, the association issued transparency guidelines, which call for disclosure of all payments to physicians, including fees for speaking, writing, and consulting as well as research funding, donations, meals, and other gifts.5 At present, only payments for speaking, writing, and consulting have been published with individual names and affiliations. Since 2013, annual payment data have been published on each company’s website.5 Compared with Open Payments6 data in the United States, these disclosures are often unclear and inconsistent: the disclosure format varies between companies, and the aggregated payment data are not readily available. We analyzed the extent and distribution of industry payments to the executive board members of professional medical associations in Japan.

    Methods

    We selected 19 major medical associations, 1 for each of the basic clinical medical fields, as categorized by the Japanese Medical Specialty Board. For 2016, we collected data on payments (fees for speaking, writing, and consulting) made to executive board members of these 19 associations from all 71 pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association. We obtained each company’s data individually through their websites and integrated the data into a single database. We then summed the payments made to each of 405 executive board members. We converted Japanese yen to US dollars using the exchange rate of ¥112 per $1 on September 21, 2018. We also reviewed the websites of the 19 medical associations to determine if the associations disclosed the payments to their executive board members to the public.

    Results

    Of 405 executive board members, 352 (86.9%) received pharmaceutical company payments (Table). The total amount paid was $6 468 585: $5 279 312 for speaking, $412 900 for writing, and $776 373 for consulting. The median payment was $7486 (interquartile range [IQR], $1767-$20 277). Of the payments, $2 960 928 (45.8%) went to the 40 executive board members who received the largest payments; 12 were on the board of the Japanese Society of Internal Medicine, 7 on the board of the Japanese Urological Association, and another 7 on the board of the Japanese Dermatological Association. The highest median payment was to the executive board members of the Japanese Society of Internal Medicine ($51 974; IQR, $33 900-$86 349). Payments to board members of the Japanese Society of Internal Medicine accounted for 20.8% of the total payments, followed by the Japanese Urological Association (14.9%) and the Japanese Dermatological Association (11.1%). We found no evidence that any of the 19 associations publicly disclosed the pharmaceutical company payments to their executive board members.

    Discussion

    In 2016, most of the executive board members of the 19 leading professional medical associations in Japan received payments from pharmaceutical companies, primarily for speaking and consulting. Executive board members of 3 medical associations—internal medicine, urology, and dermatology—accounted for 46.8% of all the payments. We found no evidence that any of these payments were publicly disclosed. The payments, as well as the lack of disclosure by the medical associations themselves, raise concerns about the potential influence of payments on professional activities.

    Limitations of our study include possible inaccuracies in the payment information and the limited types of payments that were analyzed. Information about research funding, donations, meals, and other gifts was not available. Medical device companies were not included because their payments are not sufficiently disclosed.

    It has been argued that no executive board members of professional medical associations should receive industry payments.1 Although this may remain an aspirational goal, it would be desirable if there were fewer and smaller payments and if all such payments were publicly disclosed by the associations themselves on their websites.

    Back to top
    Article Information

    Accepted for Publication: October 29, 2018.

    Corresponding Author: Hiroaki Saito, MD, Department of Gastroenterology, Sendai Kousei Hospital, 4-15, Hirose-cho, Aoba-ku, Sendai, Miyagi 980-0873, Japan (h.saito0515@gmail.com).

    Published Online: February 4, 2019. doi:10.1001/jamainternmed.2018.7283

    Author Contributions: Drs Saito and Ozaki had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

    Concept and design: Saito, Ozaki.

    Acquisition, analysis, or interpretation of data: All authors.

    Drafting of the manuscript: Saito, Ozaki.

    Critical revision of the manuscript for important intellectual content: Saito, Ozaki, Kobayashi, Sawano, Tanimoto.

    Statistical analysis: Saito, Ozaki.

    Administrative, technical, or material support: Tanimoto.

    Supervision: Sawano, Tanimoto.

    Conflict of Interest Disclosures: Dr Saito reported receiving personal fees from TAIHO Pharmaceutical Co, Ltd outside the submitted work. Drs Ozaki and Tanimoto reported receiving personal fees from Medical Network Systems outside the submitted work. No other disclosures were reported.

    Funding/Support: This study was supported by Ain Pharmacies and Waseda Chronicle.

    Role of the Funder/Sponsor: Ain Pharmacies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Waseda Chronicle was engaged in the collection and management of the payment data, but had no role in design and conduct of the study; analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

    Additional Contributions: Masahiro Kami, MD, PhD (Medical Governance Research Institute), provided his constructive opinion of the manuscript; he was not compensated for his work. Editage provided English language editing and was compensated for their work.

    References
    1.
    Rothman  DJ, McDonald  WJ, Berkowitz  CD,  et al.  Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest.  JAMA. 2009;301(13):1367-1372. doi:10.1001/jama.2009.407PubMedGoogle ScholarCrossref
    2.
    Fabbri  A, Gregoraci  G, Tedesco  D,  et al.  Conflict of interest between professional medical societies and industry: a cross-sectional study of Italian medical societies’ websites.  BMJ Open. 2016;6(6):e011124. doi:10.1136/bmjopen-2016-011124PubMedGoogle ScholarCrossref
    3.
    Tringale  KR, Marshall  D, Mackey  TK, Connor  M, Murphy  JD, Hattangadi-Gluth  JA.  Types and distribution of payments from industry to physicians in 2015.  JAMA. 2017;317(17):1774-1784. doi:10.1001/jama.2017.3091PubMedGoogle ScholarCrossref
    4.
    Japan Pharmaceutical Manufacturers Association. Data book 2018 [in Japanese]. http://www.jpma.or.jp/about/issue/gratis/databook/2018/. Published 2018. Accessed October 2, 2018.
    5.
    Japan Pharmaceutical Manufacturers Association. Transparency guideline for the relation between corporate activities and medical institutions [in Japanese]. http://www.jpma.or.jp/english/policies_guidelines/transparency_guideline.html. Published 2018. Accessed July 15, 2018.
    6.
    Centers for Medicate & Medicaid Services. Open Payments homepage. https://openpaymentsdata.cms.gov/. Accessed December 12, 2018.
    ×