Introduction
Collaborations between physicians and pharmaceutical companies play a
crucial role in advancing healthcare innovation and improving patient
care through joint research efforts. However, such collaborations can
also lead to financial conflicts of interest (COIs) for physicians.
Furthermore, physicians may engage in promotional activities or be
targeted for marketing by the companies,1-3potentially biasing their decision-making, including prescribing
patterns and guideline recommendations.4-9 These COIs
could bias physicians’ decision-making including prescribing patterns
and guideline recommendations.
To improve transparency in these financial relationships, the Japan
Pharmaceutical Manufacturers Association (JPMA), the largest
pharmaceutical trade organization in Japan, implemented a policy in 2013
requiring its member companies to disclose payments to physicians on
their websites. This data is then collected by an independent research
organization and journalists and has been voluntarily available on a
comprehensive searchable database since 2016.10Previous research using this database has revealed prevalent financial
relationships between physicians and pharmaceutical companies in
Japan.11-17
Among several specialists, cardiologists are among the most heavily
targeted specialists for marketing by pharmaceutical companies. Murayama
et al. previously reported that society executive board members of the
Japanese Circulation Society received the second highest mean payments
of $311,653, with the fourth highest median payments of $207,888 in
personal payments for lecturing, consulting, and writing among 15
internal medicine subspecialty societies in Japan.12Another study found that authors of the Japanese Society of Hypertension
clinical guidelines received a mean of $21,447 in personal payments in
2016.18 Additionally, Tringale et al. reported that
cardiologists received the highest median payments of $862 from
healthcare companies of 26 specialties in the United States
(US).2 Similarly, Murayama et al. reported that
cardiologists received $725 in personal payments in the US in
2019.1 Despite the likely presence of prevalent and
substantial financial relationships between cardiologists and
pharmaceutical companies in Japan, no studies have been conducted to
evaluate the whole size and extent of financial relationships between
cardiologists and pharmaceutical companies. Utilizing a publicly
accessible database, this study investigated the extent and trends of
personal payments from pharmaceutical companies to all cardiologists in
Japan.