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Schnog JB, Samson MJ, Gersenbluth I, Duits AJ. Pharmaceutical Industry Payments to Medical Oncologists in the Netherlands: Trends and Patterns Provided by an Open-Access Transparency Data Set. JCO Oncol Pract 2024; 20:843-851. [PMID: 38354335 DOI: 10.1200/op.23.00533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/24/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024] Open
Abstract
PURPOSE Health care expenditure related to oncologic treatments is skyrocketing although many treatments offer marginal, if any, clinical benefit. Financial conflicts of interest (fCOI) resulting from pharmaceutical industry (pharma) payments to physicians is increasingly recognized as a predictive factor for regulatory board approval and guideline incorporation of low-value treatments. We sought to study the extent to which pharma payments to medical oncologists occur in the Netherlands, the amount of money involved, and whether these occur more frequently and are higher for key opinion leaders (KOLs). METHODS In our cross-sectional retrospective database study, we used several Dutch open-access databases and extracted data registered between 2019 and 2021. RESULTS A cumulative amount of €899,863 was paid to 48.8% of the 408 registered medical oncologists. Over time, there was a marked decline in both the proportion of medical oncologists receiving payments (from 40.4% in 2019 to 19.1% in 2021) and the mean annual value of payments (from €2,962 in 2019 to €2,188 in 2021) with the latter mainly resulting from a decline in hospitality-related transactions. KOLs were more likely to receive industry payments and received a higher median payment value. DISCUSSION Our findings should contribute to the increasing awareness in the Netherlands of the potential effects of fCOI.
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Affiliation(s)
- J B Schnog
- Department of Hematology-Medical Oncology, Curaçao Medical Center, Willemstad, Curaçao
- Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
| | - M J Samson
- Department of Radiation Oncology, Curaçao Medical Center, Willemstad, Curaçao
| | - I Gersenbluth
- Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
| | - A J Duits
- Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
- Department of Medical Education, Curaçao Medical Center, Willemstad, Curaçao
- Institute for Medical Education, University Medical Center Groningen, Groningen, the Netherlands
- Red Cross Blood Bank Foundation, Willemstad, Curaçao
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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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Pokorny AMJ, Moynihan R, Fox P, Karikios DJ, Bero LA, Mintzes BJ. Australian Cancer Physicians and the Pharmaceutical Industry: A Survey of Attitudes and Interactions. JCO Oncol Pract 2022; 18:e1154-e1163. [PMID: 35316090 DOI: 10.1200/op.21.00767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Interactions between cancer physicians and the pharmaceutical industry may create conflicts of interest that can adversely affect patient care. We aimed to survey cancer physicians regarding their attitudes toward and interactions with industry. METHODS We surveyed Australian cancer physicians between December 2020 and February 2021, questioning how often they interacted with industry and their attitudes toward this. We also assessed factors associated with accepting payments from industry and the amount received, and opinions on policies and industry influence. We used logistic and linear regression to examine links between attitudes and behaviors. RESULTS There were 116 responses (94 complete). Almost half (n = 53 of 115, 46.1%) felt that there was a positive relationship between cancer physicians and industry. Most (n = 79 of 104, 76.0%) interacted with industry at least once a month, and 67.7% (n = 63 of 93) had received nonresearch payments from industry previously, with a median value of 2,000 Australian dollars over 1 year. Most respondents believed that interactions could influence prescribing while simultaneously denying influence on their own prescribing (n = 66 of 94, 70.2%). Those who judged general sales representative interactions (odds ratio [OR] 9.37 [95% CI, 1.05 to 83.41], P = .045) or clinician sponsorship (OR 3.22 [95% CI, 1.01 to 10.30], P = .049) to be more acceptable also met with sales representatives more frequently. Physicians were more likely to accept industry payments when they deemed sponsorship of clinicians for conferences (OR 10.55 [95% CI, 2.33 to 47.89], P = .002) or honoraria for advisory board membership more acceptable (OR 3.91 [95% CI, 1.04 to 14.74], P = .04) or when they had higher belief in industry influence over own prescribing (OR 25.51 [95% CI, 2.70 to 241.45], P = .005). CONCLUSION Australian cancer physicians interact with industry frequently, and those who feel positive about these interactions are likely to do so more often. More research is needed to understand the motivations behind these interactions.
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Affiliation(s)
- Adrian M J Pokorny
- Alice Springs Hospital, Northern Territory, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ray Moynihan
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Peter Fox
- Central West Cancer Care Centre, Orange, New South Wales, Australia.,School of Medicine, Western Sydney University, New South Wales, Australia
| | - Deme J Karikios
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Nepean Cancer Care Centre, Kingswood, New South Wales, Australia
| | - Lisa A Bero
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Barbara J Mintzes
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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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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