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Saito H, Ozaki A, Kobayashi Y, Sawano T, Tanimoto T. Pharmaceutical Company Payments to Executive Board Members of Professional Medical Associations in 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.
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.
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.
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.
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 (firstname.lastname@example.org).
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.