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Ethics
Original research
Pharmaceutical payments to certified oncology specialists in Japan in 2016: a retrospective observational cross-sectional analysis
  1. Akihiko Ozaki1,2,
  2. Hiroaki Saito3,
  3. Yosuke Onoue4,
  4. Toyoaki Sawano5,
  5. Yuki Shimada6,
  6. Yurie Somekawa1,
  7. Aritsune Tsuji1,
  8. Tetsuya Tanimoto1
  1. 1 Medical Governance Research Institute, Tokyo, Japan
  2. 2 Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
  3. 3 Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan
  4. 4 College of Humanities and Sciences, Nihon University, Tokyo, Japan
  5. 5 Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Japan
  6. 6 Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Japan
  1. Correspondence to Dr Akihiko Ozaki; ozakiakihiko{at}gmail.com

Abstract

Objective This 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 participants Payment 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.

Outcome Payments 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.

Results In 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.

Conclusion Financial 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.

  • conflict of interest
  • oncology specialist
  • Japan
  • industry payment
  • Japanese Society of Medical Oncology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-028805

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    Footnotes

    • Contributors AO acquired and controlled all sources of data and oversaw all data analyses. AO, HS, YO, TS, YukS, YurS, AT and TT were involved in the study concept and design. AO, HS, YO, TS, YukS, YurS, AT and TT were involved in the analysis, interpretation of results and formation of conclusions. AO drafted the manuscript.

    • Funding The Medical Governance Research Institute (MEGRI) is a non-profit enterprise, which receives donations from various organisations and individuals. Among the donors, Ain Pharmaciez Inc is part of the pharmaceutical industry. Waseda Chronicle, an independent non-profit news organisation dedicated to investigative journalism, also contributed funding to this study.

    • Disclaimer The funders made no contribution whatsoever to either the design of the study, the work carried out or the interpretation of the study findings.

    • Competing interests AO and TT receive personal fees from Medical Network Systems (MNES Inc); HS has received a research honorarium from TAIHO Pharmaceutical Co, Ltd.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the Institutional Review Board of the MEGRI on 16 May 2018.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The datasets analysed during the current study are available from the corresponding author on reasonable request.