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.