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Murayama A, Senoo Y. Pharmaceutical industry payments to authors of neurology clinical practice guidelines in Japan: A cross-sectional study. Health Sci Rep 2024; 7:e70101. [PMID: 39323464 PMCID: PMC11423335 DOI: 10.1002/hsr2.70101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 08/28/2024] [Accepted: 09/06/2024] [Indexed: 09/27/2024] Open
Affiliation(s)
- Anju Murayama
- School of Medicine Tohoku University Sendai Japan
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York USA
| | - Yuki Senoo
- Higashi Totsuka Memorial Hospital Yokohama Japan
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Murayama A, Kugo H, Senoo Y. Cross-sectional analysis of pharmaceutical industry payments to authors of clinical practice guidelines for bipolar disorder and major depressive disorder in Japan. BMJ Open 2024; 14:e086396. [PMID: 38908845 PMCID: PMC11328610 DOI: 10.1136/bmjopen-2024-086396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE Clinical practice guidelines (CPGs) are essential for standardising patient care based on evidence-based medicine. However, the presence of financial conflicts of interest (COIs) among CPG authors can undermine their credibility. This study aimed to examine the extent and size of COIs among authors of psychiatry CPGs in Japan. METHODS This cross-sectional analysis of disclosed payments from pharmaceutical companies assesses the prevalence and magnitude of personal payments for lecturing, consulting and writing to CPGs for bipolar disorder and major depressive disorder in Japan between 2016 and 2020. RESULTS This study found that 93.3% of authors received payments over a 5-year period, with total payments exceeding US$4 million. The median payment per author was US$51 403 (IQR: US$9982-US$111 567), with a notable concentration of payments among a small number of authors, including the CPG chairperson. Despite these extensive financial relationships, only a fraction of authors disclosed their COIs in the CPGs. These large amounts of personal payments were made by pharmaceutical companies manufacturing new antidepressants and sleeping aids listed in the CPGs. CONCLUSIONS This study found that more than 93% of authors of CPGs for major depressive disorder and bipolar disorder in Japan received considerable amounts of personal payments from the pharmaceutical industry. The findings highlight deviations from international COI management standards and suggest a need for more stringent COI policies for psychiatry CPGs in Japan.
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Affiliation(s)
- Anju Murayama
- Tohoku University School of Medicine, Sendai, Miyagi, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hinari Kugo
- Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Yuki Senoo
- Higashi Totsuka Kinen Byoin, Yokohama, Kanagawa, Japan
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Murayama A, Aizawa M, Byreddy KR, Higuchi K, Senoo Y. Conflicts of Interest Among Cardiology Clinical Practice Guideline Authors in Japan. J Am Heart Assoc 2024; 13:e034506. [PMID: 38606773 PMCID: PMC11262514 DOI: 10.1161/jaha.124.034506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Clinical practice guidelines (CPGs) offer disease management recommendations based on scientific evidence. However, financial conflicts of interest between CPG developers and the pharmaceutical industry could bias these recommendations, potentially affecting patient care. Proper management of these conflicts of interest is particularly crucial for maintaining the integrity of CPGs. The study aimed to evaluate the extent of financial relationships between the pharmaceutical industry and authors of CPGs for cardiovascular diseases in Japan. METHODS AND RESULTS The study analyzed personal payments from the pharmaceutical industry to authors of cardiovascular disease CPGs published by the Japanese Circulation Society from January 2015 to December 2022. Payment data, including speaking, consultancy, and writing fees from 2016 to 2020, were extracted from a publicly available database containing personal payments disclosed by all major pharmaceutical companies. A total of 929 unique authors from 37 eligible Japanese Circulation Society CPGs were identified. Notably, 94.4% of these authors received personal payments from pharmaceutical companies, totaling >US $70.8 million. The mean±SD payment per author was US $76 314±138 663) and the median payment per author was US $20 792 (interquartile range: US $4262-US $76 998) over the 5-year period. Chairs of CPGs received significantly higher payments than other authors. More than 80% of authors in each CPG received personal payments. CONCLUSIONS The study elucidated that there were considerable financial relationships between pharmaceutical companies and cardiology CPG authors in Japan. This finding deviates from international conflict of interest management policies, suggesting the need for more stringent conflict of interest management strategies by the Japanese Circulation Society to ensure the development of trustworthy and evidence-based CPGs.
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Affiliation(s)
- Anju Murayama
- Tohoku University School of MedicineSendaiMiyagiJapan
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Megumi Aizawa
- Department of Industrial Engineering and EconomicsTokyo Institute of TechnologyMeguroTokyoJapan
| | - Keerthana R. Byreddy
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | | | - Yuki Senoo
- Higashi Totsuka Memorial HospitalYokohamaKanagawaJapan
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Murayama A, Senoo Y. Cross-sectional analysis of financial relationships between board certified allergists and the pharmaceutical industry in Japan. BMC Med Ethics 2024; 25:22. [PMID: 38378633 PMCID: PMC10880373 DOI: 10.1186/s12910-024-01014-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Financial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020. METHODS A retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends were analyzed using generalized estimating equation models. RESULTS Of the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 - $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 - 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic. CONCLUSION The majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic's onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba ward, Sendai City, Miyagi, 980-0872, Japan.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Yuki Senoo
- Higashi Totsuka Memorial Hospital, Yokohama City, Kanagawa, Japan
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Murayama A, Kamamoto S, Kugo H, Saito H, Ozaki A. Research and Nonresearch Industry Payments to Nephrologists in the United States between 2014 and 2021. J Am Soc Nephrol 2023; 34:1709-1720. [PMID: 37488676 PMCID: PMC10561777 DOI: 10.1681/asn.0000000000000172] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/29/2023] [Indexed: 07/26/2023] Open
Abstract
SIGNIFICANCE STATEMENT Concerns about the financial relationships between nephrologists and the health care industry have been reported in the United States over the past decade. However, since the 2014 launch of the federal transparency database, Open Payments, few documents have explored the whole picture of research and nonresearch payments to US nephrologists from industry sources. In this study, the authors found that 87% of nephrologists have received nonresearch payments, and the aggregate amount of these payments has been increasing since 2014. Only 12% of nephrologists received research payments; these recipients were disproportionately male. In addition, the top 5% of nephrologists receiving nonresearch funds received 81% of all such payments. Nonresearch payments were larger among male nephrologists than among female nephrologists and increased by 8% annually among male nephrologists between 2014 and 2019. BACKGROUND Financial relationships between nephrologists and the health care industry have been a concern in the United States over the past decade. METHODS To evaluate industry payments to nephrologists, we conducted a cross-sectional study examining nonresearch and research payments to all US nephrologists registered in the National Plan and Provider Enumeration System between 2014 and 2021, using the Open Payments database. Payment data were descriptively analyzed on the basis of monetary value, and payment trends were evaluated by using a generalized estimating equations model. RESULTS From 2014 through 2021, 10,463 of 12,059 nephrologists (87%) received at least one payment from the US health care industry, totaling $778 million. The proportion of nephrologists who did not receive nonresearch payments varied each year, ranging from 38% to 51%. Nonresearch payments comprised 22% ($168 million) of overall industry payments in monetary value but 87% in the number of payments. Among those receiving payments, the median per-physician 8-year aggregated payment values were $999 in nonresearch payments and $102,329 in associated research payments. Male nephrologists were more likely than female nephrologists to receive research payments, but the per-physician amount did not differ. However, nonresearch payments were three times larger for male nephrologists and increased by 8% annually between 2014 and 2019 among male nephrologists but remained stable among female nephrologists. The top 5% of nephrologists receiving nonresearch payments received 81% of all such payments. CONCLUSIONS Between 2014 and 2021, 87% of US nephrologists received at least one payment from the health care industry. Notably, nonresearch payments to nephrologists have been increasing since the Open Payments database's 2014 launch. Male nephrologists were more likely than female nephrologists to receive research payments.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Japan
| | - Sae Kamamoto
- School of Medicine, Hamamatsu University, Hamamatsu, Japan
| | - Hinari Kugo
- School of Medicine, Tohoku University, Sendai, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Tokyo, Japan
- Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital, Fukushima, Japan
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Murayama A. Financial Conflicts of Interest Among the Authors of the Clinical Practice Guidelines for Rheumatoid Arthritis in Japan. Cureus 2023; 15:e46650. [PMID: 37937008 PMCID: PMC10627577 DOI: 10.7759/cureus.46650] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To assess the financial relationships between pharmaceutical companies and authors of the 2020 Japan College of Rheumatology Clinical Practice Guidelines (CPG) for the Management of Rheumatoid Arthritis and to evaluate the quality of evidence supporting the guideline recommendations. Methods This retrospective study evaluated financial relationships between all 27 authors of the CPG and pharmaceutical companies in Japan. Personal payments from pharmaceutical companies to these authors between 2016 and 2020 were extracted from publicly disclosed databases for each pharmaceutical company. The quality of the evidence supporting the CPG recommendations was also assessed. Results All 27 authors received personal payments from pharmaceutical companies, totaling $3,683,048 over five years. The median and mean payments per author were $101,624 and $136,409, respectively. Speaking compensations accounted for more than 80% of all personal payments. More than 77.8% (21 authors), 66.7% (18 authors), and 51.9% (14 authors) received more than $10,000, $50,000, and $100,000 in total payments over the five years, respectively. Nevertheless, these financial relationships between the CPG authors and pharmaceutical companies were not disclosed. More than 81.8% of the CPG recommendations were supported by low- or very-low-quality evidence. Of the strong recommendations, 66.7% were supported by low- or very-low-quality evidence. Conclusion Even though all CPG authors received substantial amounts of personal payments from pharmaceutical companies, these conflicts of interest (COIs) were not disclosed in the CPG. These findings underscore the urgent need for policy interventions to enhance transparency, integrity, and reliability in the development of CPGs in Japan.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, JPN
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
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Murayama A, Kamamoto S, Murata N, Yamasaki R, Yamada K, Yamashita E, Saito H, Tanimoto T, Ozaki A. Evaluation of financial conflicts of interest and quality of evidence in Japanese gastroenterology clinical practice guidelines. J Gastroenterol Hepatol 2022; 38:565-573. [PMID: 36518089 DOI: 10.1111/jgh.16089] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Clinical practice guidelines assist healthcare professionals in providing evidence-based care. However, pharmaceutical companies' financial interests often influence guideline content. This study aimed to elucidate the magnitude of financial ties among Japanese gastroenterology guideline authors and the pharmaceutical industry. METHODS Using pharmaceutical company disclosed payment data, we evaluated financial conflicts of interest (COI) among Japanese Society of Gastroenterology guideline authors between 2016 and 2021. Additionally, we assessed the evidence quality supporting guideline recommendations and associations with financial COI. Finally, we evaluated author COI management during guideline development against global standards. RESULTS Overall, 88.2% (231/262) of guideline authors received a median of $12 968 (interquartile range [IQR]: $1839-$70 374) in payments between 2016 and 2019 for lectures, writings, and consulting. Chairpersons received significantly higher payments (median: $86 444 [IQR: $15 455-$165 679]). Notably, 41 (15.6%) authors had undeclared payments exceeding declaration requirements. Low or very low-quality evidence supported 41.0% of recommendations. There was a negative association between the median 4-year payment per author and the proportion of recommendations based on low-quality evidence (odds ratio: 0.966 [95% confidence interval [95% CI]: 0.945-0.987], P = 0.002) and positive association with moderate-quality evidence (odds ratio: 1.018 [95% CI: 1.011-1.025], P < 0.001). Still, the Japanese Society of Gastroenterology guideline development process remains less transparent, with insufficient COI policies relative to global standards. CONCLUSION There were extensive financial COI between pharmaceutical companies and guideline authors, and more than 40% of recommendations were based on low-quality evidence. More rigorous and transparent COI policies for guideline development adhering to global standards are warranted.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Faculty of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Nanami Murata
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Faculty of Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Ryota Yamasaki
- Faculty of Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Kohki Yamada
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Osaka University School of Medicine, Osaka, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
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Mamada H, Murayama A, Kamamoto S, Kaneda Y, Yoshida M, Sugiura S, Yamashita E, Kusumi E, Saito H, Sawano T, Tanimoto T, Vassar M, Ozieranski P, Ozaki A. Evaluation of Financial and Nonfinancial Conflicts of Interest and Quality of Evidence Underlying Psoriatic Arthritis Clinical Practice Guidelines: Analysis of Personal Payments From Pharmaceutical Companies and Authors' Self-Citation Rate in Japan and the United States. Arthritis Care Res (Hoboken) 2022; 75:1278-1286. [PMID: 36194077 DOI: 10.1002/acr.25032] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/19/2022] [Accepted: 09/27/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To assess financial conflicts of interest (COI) and nonfinancial COI among psoriatic arthritis (PsA) clinical practice guideline (CPG) authors in Japan and the US, and to evaluate the quality of evidence and strength of recommendations of PsA CPGs. METHODS We performed a retrospective analysis using payment data from major Japanese pharmaceutical companies and the US Open Payments Database from 2016 to 2018. All authors of PsA CPGs issued by the Japanese Dermatological Association (JDA) and American College of Rheumatology (ACR) were included. RESULTS Of 23 CPG authors in Japan, 21 (91.3%) received at least 1 payment, with a combined total of $3,335,413 between 2016 and 2018. Regarding 25 US authors, 21 (84.0%) received at least 1 payment, with a combined total of $4,081,629 during the same period. The 3-year combined mean ± SD payment per author was $145,018 ± $114,302 in Japan and $162,825 ± $259,670 in the US. A total of 18 authors (78.3%) of the JDA PsA CPG and 12 authors (48.0%) of the ACR PsA CPG had undisclosed financial COI worth $474,663 and $218,501, respectively. The percentage of citations with at least 1 CPG author relative to total citations was 3.4% in Japan and 33.6% in the US. In sum, 71.4% and 88.8% of recommendations for PsA in the JDA and ACR were supported by low or very low quality of evidence. CONCLUSION More rigorous cross-checking of information disclosed by pharmaceutical companies and self-reported by physicians and more stringent and transparent COI policies are necessary.
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Affiliation(s)
- Hanano Mamada
- Medical Governance Research Institute, Minato-ku, and Akita University, Akita, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato-ku, and Tohoku University school of Medicine, Sendai, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato-ku, and Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yudai Kaneda
- Medical Governance Research Institute, Minato-ku, and Hokkaido University School of Medicine, Sapporo, Japan
| | | | - Sota Sugiura
- Medical Governance Research Institute, Minato-ku, Japan
| | | | | | | | | | | | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa
| | | | - Akihiko Ozaki
- Jyoban Hospital of Tokiwa Foundation and Medical Governance Research Institute, Iwaki, Japan
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Murayama A, Yamada K, Yoshida M, Kaneda Y, Saito H, Sawano T, Shrestha S, Shrestha R, Tanimoto T, Ozaki A. Evaluation of Conflicts of Interest among Participants of the Japanese Nephrology Clinical Practice Guideline. Clin J Am Soc Nephrol 2022; 17:819-826. [PMID: 35623883 PMCID: PMC9269663 DOI: 10.2215/cjn.14661121] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/07/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Rigorous and transparent management strategies for conflicts of interest and clinical practice guidelines with the best available evidence are necessary for the development of nephrology guidelines. However, there was no study assessing financial and nonfinancial conflicts of interest, quality of evidence underlying the Japanese guidelines for CKD, and conflict of interest policies for guideline development. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This cross-sectional study examined financial and nonfinancial conflicts of interest among all 142 authors of CKD guidelines issued by the Japanese Society of Nephrology using a personal payment database from all 92 major Japanese pharmaceutical companies between 2016 and 2019 and self-citations by guideline authors. Also, the quality of evidence and strength of recommendations underlying the guidelines and conflicts of interest policies of Japanese, US, and European nephrology societies were evaluated. RESULTS Among 142 authors, 125 authors (88%) received $6,742,889 in personal payments from 56 pharmaceutical companies between 2016 and 2019. Four-year combined median payment per author was $8258 (interquartile range, $2230‒$51,617). The amounts of payments and proportion of guideline authors with payments remained stable during and after guideline development. The chairperson, vice chairperson, and group leaders received higher personal payments than other guideline authors. Of 861 references in the guidelines, 69 (8%) references were self-cited by the guideline authors, and 76% of the recommendations were on the basis of low or very low quality of evidence. There were no fully rigorous and transparent conflicts of interest policies for nephrology guideline authors in the United States, Europe, and Japan. CONCLUSIONS Most of the Japanese CKD guideline recommendations were on the basis of low quality of evidence by the guideline authors tied with pharmaceutical companies, suggesting the need for better financial conflicts of interest management.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Tokyo, Japan
- Tohoku University School of Medicine, Miyagi, Japan
| | - Kohki Yamada
- Medical Governance Research Institute, Tokyo, Japan
| | | | - Yudai Kaneda
- Medical Governance Research Institute, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | - Rajeev Shrestha
- Department of Pharmacy, District Hospital Lamjung, Lamjung, Nepal
| | | | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
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Murayama A, Senoo Y, Harada K, Kotera Y, Saito H, Sawano T, Suzuki Y, Tanimoto T, Ozaki A. Awareness and Perceptions among Members of a Japanese Cancer Patient Advocacy Group Concerning the Financial Relationships between the Pharmaceutical Industry and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063478. [PMID: 35329160 PMCID: PMC8952770 DOI: 10.3390/ijerph19063478] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
Objectives: Awareness and perceptions of financial conflicts of interest (FCOI) between pharmaceutical companies (Pharma) and healthcare domains remain unclear in Japanese cancer patient communities. This study aimed to assess awareness (RQ1), the influence of FCOI on physician trustworthiness (RQ2), and their perception (RQ3) among the Japanese cancer patient advocacy group members. Methods: A cross-sectional study using a self-administered survey was conducted with a Japanese cancer patient advocacy group between January and February 2019. The main outcome measures included awareness and perceptions of physician–Pharma interactions, their impact on physician trustworthiness, and attitudes towards FCOI among medical and other professions. Furthermore, we performed thematic analyses on the comments which responders provided in the surveys. Results: Among the 524 contacted members, 96 (18.3%) completed the questionnaire, including 69 (77.5%) cancer patients. In RQ1, most of the respondents were aware of physician–Pharma interactions, although the extent differed based on the nature of the interaction. Furthermore, the respondents mainly considered these interactions influential on clinical practice (RQ2) and agreed to the need for further regulation of physician–Pharma interactions (QR3). In qualitative analyses (n = 56), we identified the 4 following themes: perception towards the FCOI (Theme 1), concerns about the respondent’s treatment (Theme 2), reason of physician–Pharma interactions (Theme 3), and possible solutions from the patient perspective (Theme 4). Conclusions: Most respondents were generally aware of physician–Pharma-associated FCOI and perceived them negatively. Additionally, participants appeared supportive of further FCOI regulation to protect patient-centred care. Abbreviations: FCOI—financial conflicts of interest; United States—US; Pharma—pharmaceutical companies; RQ—research question.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan; (Y.S.); (K.H.); (Y.S.); (T.T.); (A.O.)
- School of Medicine, Tohoku University, Sendai 980-8574, Japan
- Correspondence: ; Tel.: +81-90-6321-6996
| | - Yuki Senoo
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan; (Y.S.); (K.H.); (Y.S.); (T.T.); (A.O.)
| | - Kayo Harada
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan; (Y.S.); (K.H.); (Y.S.); (T.T.); (A.O.)
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai 980-0873, Japan;
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan;
| | - Yosuke Suzuki
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan; (Y.S.); (K.H.); (Y.S.); (T.T.); (A.O.)
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan; (Y.S.); (K.H.); (Y.S.); (T.T.); (A.O.)
- Department of Internal Medicine, Navitas Clinic Kawasaki, Tokyo 210-0007, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan; (Y.S.); (K.H.); (Y.S.); (T.T.); (A.O.)
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
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Interactions with the pharmaceutical industry and the practice, knowledge and beliefs of medical oncologists and clinical haematologists: a systematic review. Br J Cancer 2022; 126:144-161. [PMID: 34599297 PMCID: PMC8727671 DOI: 10.1038/s41416-021-01552-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 08/23/2021] [Accepted: 09/15/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND No previous review has assessed the extent and effect of industry interactions on medical oncologists and haematologists specifically. METHODS A systematic review investigated interactions with the pharmaceutical industry and how these might affect the clinical practice, knowledge and beliefs of cancer physicians. MEDLINE, Embase, PsycINFO and Web of Science Core Collection databases were searched from inception to February 2021. RESULTS Twenty-nine cross-sectional and two cohort studies met the inclusion criteria. These were classified into three categories of investigation: (1) extent of exposure to industry for cancer physicians as whole (n = 11); (2) financial ties among influential cancer physicians specifically (n = 11) and (3) associations between industry exposure and prescribing (n = 9). Cancer physicians frequently receive payments from or maintain financial ties with industry, at a prevalence of up to 63% in the United States (US) and 70.6% in Japan. Among influential clinicians, 86% of US and 78% of Japanese oncology guidelines authors receive payments. Payments were associated with either a neutral or negative influence on the quality of prescribing practice. Limited evidence suggests oncologists believe education by industry could lead to unconscious bias. CONCLUSIONS There is substantial evidence of frequent relationships between cancer physicians and the pharmaceutical industry in a range of high-income countries. More research is needed on clinical implications for patients and better management of these relationships. REGISTRATION PROSPERO identification number CRD42020143353.
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Murayama A, Kida F, Ozaki A, Saito H, Sawano T, Tanimoto T. Financial and Intellectual Conflicts of Interest Among Japanese Clinical Practice Guidelines Authors for Allergic Rhinitis. Otolaryngol Head Neck Surg 2021; 166:869-876. [PMID: 34399654 DOI: 10.1177/01945998211034724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To elucidate financial and intellectual conflicts of interest (COIs) among clinical practice guideline (CPG) authors of allergic rhinitis in Japan and to evaluate the extent of transparency and accuracy in COIs by CPG authors of allergic rhinitis. STUDY DESIGN A cross-sectional analysis of the payment data from all 79 pharmaceutical companies in Japan between 2016 and 2017. SETTING Japan. METHODS We considered all 27 CPG authors from 2 different versions of the most prominent CPGs for allergic rhinitis in Japan. Using payment data disclosed by 79 major pharmaceutical companies between 2016 and 2017, we assessed the magnitude and characteristics of financial COIs of CPG authors. We also evaluated the intellectual COIs of the CPG authors by counting self-citations of research articles related to CPG statements and recommendations. RESULTS Of 27 CPG authors, 26 authors (96.3%) received at least 1 payment from a combined total of $1,333,552 between 2016 and 2017. The 2-year combined average and median monetary values per author were $49,391 (SD, $67,438) and $18,400 (interquartile range: $6,216-$72,494), respectively. Pharmaceutical companies with novel drugs predominantly made these payments. The percentage of citations with at least 1 CPG author relative to total citations was 47.6% in 2016 and 27.9% in 2020. There were no formal COI disclosure statements in either version. CONCLUSION This study found that allergic rhinitis CPG authors had significant financial relationships with pharmaceutical companies, particularly those marketing novel drugs. In addition, CPG authors had relatively high self-citation rates, a potential marker of intellectual COIs. More rigorous and comprehensive COI management strategies are needed.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Futa Kida
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo, Japan
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