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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 DOI: 10.1161/jaha.124.034506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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 Medicine Sendai Miyagi Japan
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA
| | - Megumi Aizawa
- Department of Industrial Engineering and Economics Tokyo Institute of Technology Meguro Tokyo Japan
| | - Keerthana R Byreddy
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA
| | | | - Yuki Senoo
- Higashi Totsuka Memorial Hospital Yokohama Kanagawa Japan
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Murayama A. Financial conflicts of interest among authors of clinical practice guidelines for diabetes mellitus in Japan. J Diabetes 2024; 16:e13533. [PMID: 38599834 PMCID: PMC11006597 DOI: 10.1111/1753-0407.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 04/12/2024] Open
Affiliation(s)
- Anju Murayama
- Tohoku University School of MedicineSendaiJapan
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Murayama A, Higuchi K, Senoo Y. Financial Relationships Between Pharmaceutical Companies and Internal Medicine Societies. JAMA Netw Open 2024; 7:e244777. [PMID: 38568694 PMCID: PMC10993069 DOI: 10.1001/jamanetworkopen.2024.4777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/02/2024] [Indexed: 04/05/2024] Open
Abstract
This cross-sectional study uses payment data publicly disclosed by pharmaceutical companies affiliated with the Japan Pharmaceutical Manufacturers Association to describe their financial relationships with the subspecialty societies of the Japanese Society of Internal Medicine.
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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
| | | | - Yuki Senoo
- Higashi Totsuka Memorial Hospital, Yokohama, Kanagawa, Japan
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Murayama A. Pharmaceutical industry-sponsored meals are associated with increased prescriptions and Medicare spending for dupilumab among dermatologists in the United States. J Eval Clin Pract 2024; 30:435-439. [PMID: 38149692 DOI: 10.1111/jep.13956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
RATIONALE Healthcare industry sometimes make large marketing payments to physicians. Previous studies have demonstrated that there are significant associations between industry marketing practices and physicians' prescribing behaviours in several specialties. Given the current increasing introduction of many novel biologics for atopic dermatitis and increasing payments to dermatologists, the industry payments to dermatologists for atopic dermatitis drugs could be associated with their prescribing patterns in the United States. AIMS AND OBJECTIVES This study aims to evaluate association between dermatologists' dupilumab prescription behaviours and manufacturer's sponsored meal payments to dermatologists in the United States. METHOD Using the Centers for Medicare and Medicaid Services and the Open Payments Database, this cross-sectional analysis evaluated associations between manufacturer's sponsored meal payments to dermatologists related to dupilumab and dermatologists' dupilumab prescriptions between 2017 and 2021. Associations were evaluated using logistic generalised estimating equations (GEE) and negative binomial regression GEE models at individual dermatologist level. RESULTS Among 2852 dermatologists prescribing dupilumab, 74.5% received meal payments amounting to $1,083,919 between 2017 and 2021. Dermatologists receiving meal payments were more likely to prescribe dupilumab (odds ratio 1.50, 95% confidence interval [CI]: 1.37-1.65). There were also consistent dose-response associations between meal payments and total claims as well as Medicare spending. Dermatologists who received 1, 2-5, 6-10, and 11-15 meal payments per year reported 1.13 (95% CI: 1.03-1.24, p < 0.05), 1.35 (95% CI: 1.24-1.46, p < 0.001), 1.64 (95% CI: 1.48-1.82, p < 0.001), and 2.10 (95% CI: 1.78-2.47, p < 0.001) times more dupilumab-related claims in the year when they received the payments than those who did not receive the payments, respectively. CONCLUSION This study found that significant associations between industry-sponsored meal payments and increased dupilumab prescriptions, shedding light on the potential influence of financial relationships on clinical practice. The findings call for heightened awareness among dermatologists, patients, and policymakers regarding the impact of these relationships on healthcare expenditures and decision-making in the United States. Future research is warranted to further explore these associations longitudinally.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Murayama A, Shin N, Higuchi K, Kohli I, Kugo H, Senoo Y. Financial conflicts of interest between infectious diseases clinical practice guideline authors and the pharmaceutical industry in Japan. Infect Dis (Lond) 2024; 56:330-334. [PMID: 38299873 DOI: 10.1080/23744235.2024.2309351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 02/02/2024] Open
Affiliation(s)
- Anju Murayama
- Tohoku University School of Medicine, Sendai City, Miyagi, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Naoki Shin
- Faculty of Medicine, School of Medicine, International University of Health and Welfare, Narita City, Chiba, Japan
| | - Kenichi Higuchi
- Tohoku University School of Medicine, Sendai City, Miyagi, Japan
| | - Isha Kohli
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Hinari Kugo
- Tohoku University School of Medicine, Sendai City, Miyagi, Japan
| | - Yuki Senoo
- Higashitotsuka Memorial Hospital, Yokohama City, Kanagawa, Japan
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Murayama A, Higuchi K, Senoo Y. Pharmaceutical Industry Payments to Professional Medical Societies in Japan. J Gen Intern Med 2024:10.1007/s11606-024-08735-5. [PMID: 38519746 DOI: 10.1007/s11606-024-08735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Kenichi Higuchi
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan
| | - Yuki Senoo
- Higashi Totsuka Memorial Hospital, Yokohama, Kanagawa, Japan
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Murayama A. Evaluation of research and non-research industry payments to endocrinologists in the United States: An analysis of the Open Payments Database from 2014 to 2022. Diabet Med 2024; 41:e15253. [PMID: 37915281 DOI: 10.1111/dme.15253] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Murayama A. A Nine-Year Investigation of Industry Research and Nonresearch Payments to Emergency Physicians in the United States Between 2014 and 2022. J Emerg Med 2024; 66:e293-e303. [PMID: 38290882 DOI: 10.1016/j.jemermed.2023.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Financial relationships between physicians and the health care industry are common in the United States. Yet, there are limited data on payments to emergency physicians since the 2014 launch of the Open Payments Database. OBJECTIVES To analyze the trends and characteristics of industry payments to U.S. emergency physicians from 2014 to 2022. METHODS This retrospective study used the Open Payments Database to examine all general and research payments to all active emergency physicians. Descriptive statistics and generalized estimating equations were employed. RESULTS Between 2014 and 2022, 50.1% (33,021) of emergency physicians received $640.1 million in payments. Of these, 50.1% received general payments, and 1.2% received research payments. General payments constituted 18.7% ($119.7 million) of the overall industry payments. Median general and research payments were $149 ($49-$401) and $72,083 ($13,903-$370,142), respectively. Compared with other specialties, fewer emergency physicians received general payments, and the amounts were lower. The top 1% of emergency physicians received 80.5% of the general payments. No significant trends in payment amounts were observed from 2014 to 2019, but there was a significant decrease in both types of payments in 2020 due to the COVID-19 pandemic. CONCLUSIONS The majority of emergency physicians received payments from the health care industry, although these payments were typically minimal compared with other specialties. Payment trends remained consistent from 2014 to 2019, with a notable decrease in 2020 due to the pandemic.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan
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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] [What about the content of this article? (0)] [Affiliation(s)] [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, Kugo H, Kamamoto S. Evaluation of non-research and research industry payments to pediatric hematologist/oncologists in the United States between 2013 and 2021. Leuk Lymphoma 2024:1-9. [PMID: 38349842 DOI: 10.1080/10428194.2024.2317344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
Financial interactions between healthcare industry and pediatric hematologist/oncologists (PHOs) could be conflicts of interest. Nevertheless, little is known about financial relationships between healthcare industry and PHOs. This cross-sectional analysis of the Open Payments Database examined general and research payments to PHOs from healthcare industry in the United States between 2013 and 2021. Payments to the PHOs were analyzed descriptively. Trends in payments were assessed using generalized estimating equation models. Of 2784 PHOs, 2142 (76.9%) PHOs received payments totaling $187.3 million from the healthcare industry between 2013 and 2021. Approximately, $46.3 million (24.8%) were general payments and $137.7 million (73.5%) were funding for research where PHOs served as principal investigators (associated research funding). Both general payments and associated research funding considerably increased between 2014 and 2019. The number of PHOs receiving general payments and associated research funding annually increased by 2.2% (95% CI: 1.2-3.3%, p < .001) and 5.0% (95% CI: 3.3-6.8%, p < .001) between 2014 and 2019, respectively.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Hinari Kugo
- School of Medicine, Tohoku University, Sendai City, Japan
| | - Sae Kamamoto
- Hamamatsu University School of Medicine, Hamamatsu, Japan
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Murayama A, Marshall DC. Associations between pharmaceutical industry payments to physicians and prescription of PARP inhibitors in the United States. Gynecol Oncol 2024; 181:83-90. [PMID: 38147713 DOI: 10.1016/j.ygyno.2023.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE To evaluate the association between industry payments to physicians related to poly (ADP-ribose) polymerase inhibitors (PARPis) and physicians' prescribing behaviors for PARPis. METHODS This panel-data analysis used the publicly accessible Open Payments Database and Medicare Part D database between 2017 and 2021. All physicians who reported >10 claims for either olaparib, rucaparib, or niraparib were included in this study. Non-research payments for the PARPis to the physicians from the PARPi manufacturers were extracted from the Open Payments Database. Associations between the physicians' receipt of payments and likelihood of prescribing PARPis were assessed with logistic generalized estimating equations (GEEs). Dose-response associations between the number of payments and prescription volumes and Medicare expenditures were evaluated with linear GEEs. RESULTS Of the 1686 eligible physician prescribers, 68.7% received one or more non-research payments related to any of the three PARPis from the manufacturers between 2017 and 2021. Median annual payments per physician were $57 for olaparib, $39 for rucaparib, and $62 for niraparib. Receipt of payments for each PARPi was associated with higher odds of prescribing olaparib (odds ratio [OR]: 1.30 [95% CI: 1.14-1.48], p < 0.001), rucaparib (OR: 2.07 [95% CI: 1.58-2.72], p < 0.001), and niraparib (OR: 1.49 [95% CI: 1.22-1.81], p < 0.001). Dose-response effects were observed between the number of annual payments and the number of prescriptions and/or Medicare expenditures for olaparib and rucaparib. CONCLUSION Non-research payments to physician prescribers of PARP inhibitors from the manufacturers were significantly associated with increased prescriptions and Medicare expenditures for olaparib and rucaparib in the United States.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Deborah C Marshall
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
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Murayama A. Financial conflicts of interest among infectious disease journal editors in the USA. Int J Antimicrob Agents 2024; 63:107045. [PMID: 38052343 DOI: 10.1016/j.ijantimicag.2023.107045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Suzuki T, Tanimoto T, Kamamoto S, Ozaki A, Torii HA, Hase D, Murayama A, Yoshimura H, Uno K. Characteristics of Japanese physician influencers on Twitter during the COVID-19 pandemic and fact-checking their tweets on COVID-19-related drugs. Postgrad Med J 2024; 100:91-95. [PMID: 37968828 DOI: 10.1093/postmj/qgad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/19/2023] [Accepted: 09/21/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND During the coronavirus disease-2019 (COVID-19) pandemic, segments of the public relied on social media platforms such as Twitter for medical information shared by medical personnel. Although physicians are likely to disseminate more accurate information on Twitter than non-medical individuals, it cannot be taken for granted. As such, tweets written by physicians in Japan should also be scrutinized for accuracy. PURPOSE The purpose of this study was to create a profile of the most popular physician influencers on Twitter in Japan, and to do a fact-check of their tweets regarding COVID-19-related drugs. DESIGN This is a retrospective observational study. METHODS We purchased Twitter data for Japan for the initial 9 months of the COVID-19 pandemic (from January 2020 to September 2020), and extracted tweets with keywords related to COVID-19 at a sampling rate of 3%. The most popular physicians were identified and selected consecutively by searching for the top 1000 accounts using Twitter's search function. These top accounts were considered influencers and their tweets and retweets concerning COVID-19-related drugs were fact-checked against scientific literature. RESULTS We identified 21 physician influencers with real names: most were male in their 40s and 50s working at private medical facilities. The contents of their tweets were mainly sourced from scientific publications that were current at that time. The fact-check revealed that only one of 50 tweets was not correct while the others had no identifiable inaccuracies. CONCLUSIONS Except for one tweet, tweets written and retweeted by Japanese physician influencers concerning the COVID-19-related drugs contained predominantly accurate information.
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Affiliation(s)
- Tomoya Suzuki
- Medical Governance Research Institute, Minato, Tokyo 108-0074, Japan
- School of Medicine, Akita University, Akita 010-8543, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato, Tokyo 108-0074, Japan
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo 190-0023, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato, Tokyo 108-0074, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Shizuoka 431-3125, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato, Tokyo 108-0074, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima 972-8322, Japan
| | - Hiroyuki A Torii
- School of Science, The University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - Daisuke Hase
- School of Engineering, The University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - Anju Murayama
- Tohoku University School of Medicine, Sendai, Miyagi 980-8575, Japan
| | - Hiroki Yoshimura
- Medical Governance Research Institute, Minato, Tokyo 108-0074, Japan
- School of Medicine, Hiroshima University, Hiroshima 734-8553, Japan
| | - Kazuko Uno
- Louis Pasteur Center for Medical Research, Sakyo, Kyoto 606-8225, Japan
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Murayama A, Kugo H, Senoo Y. Letter to Japanese physicians' perceptions of conflicts of interest with pharmaceutical companies: Estimating two different questioning approaches. Int J Health Plann Manage 2024. [PMID: 38215033 DOI: 10.1002/hpm.3768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
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
- Higashitotsuka Memorial Hospital, Yokohama, Kanagawa, Japan
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Murayama A. Industry-sponsored meal payments are associated with prescriptions and Medicare expenditures on brand-name colchicine in the United States. Int J Rheum Dis 2024; 27:e14962. [PMID: 37923570 DOI: 10.1111/1756-185x.14962] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
AIM To investigate the association between industry-sponsored meal payments and the prescribing patterns of brand-name colchicines, namely Colcrys and Mitigare, among Medicare beneficiaries in the United States from 2014 to 2021. METHODS This cross-sectional study utilized data from the Open Payments Database and Medicare Part D covering the years 2014 to 2021. The study included 54 836 physicians who submitted more than 10 colchicine claims. Exposure was defined as the receipt of one or more industry-sponsored meals from the manufacturers of Colcrys or Mitigare. The primary outcomes included the likelihood of prescribing Colcrys and Mitigare, as well as the associated number of claims and Medicare expenditures. RESULTS Among 54 836 eligible physicians, 44.9% received meal payments from the Colcrys manufacturer, and 8.0% from the Mitigare manufacturer, over the eight-year study period. The average meal payment value was $14.9 for Colcrys and $15.1 for Mitigare. The receipt of meal payments was significantly associated with an increased likelihood of prescribing Colcrys (odds ratio: 1.24 [95% CI: 1.21-1.27], p < .001) and Mitigare (odds ratio: 3.54 [95% CI: 2.98-4.20], p < .001). Each additional meal payment corresponded with a significant increase in Medicare expenditures: $55.4 (95% CI: $48.3-$62.5, p < .001) for Colcrys and $153.7 (95% CI: $17.7-$289.6, p = .03) for Mitigare. These associations remained consistent across different specialties and genders. CONCLUSION This study reveals that receipt of meal payments from manufacturers of brand-name colchicine was significantly associated with an increased rate of prescriptions for these brand-name drugs, leading to higher Medicare expenditures in the United States.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Murayama A. Industry Payments to Pediatricians in the United States Between 2013 and 2021. Clin Pediatr (Phila) 2023:99228231218850. [PMID: 38102791 DOI: 10.1177/00099228231218850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Financial relationships between physicians and the health care industry sometimes lead to conflicts of interest and need to be properly managed. Using the Open Payments Database between 2013 and 2021, this cross-sectional analysis examined the industry payments made to physicians whose primary specialty was pediatrics. Descriptive analyses were performed for the payment data overall and other pediatrician demographics. Of 99 764 eligible pediatricians, 59 984 (60.1%) received a total of $297 million (12.8%) in general and $2 billion in research payments over the 9 years. Median 9-year per-physician payments were $288 (interquartile range [IQR]: $88-$958) in general and $65 343 (IQR: $16 763-$255 208) in research payments. Male pediatricians were 1.06 (95% CI: 1.05-1.09, P < .001) and 1.56 (95% CI: 1.49-1.65, P < .001) times more likely to receive general and associated research payments than female pediatricians, respectively. The number of pediatricians receiving general payments annually decreased by 1.5% (95% CI: -1.7% to -1.4%, P < .001).
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Affiliation(s)
- Anju Murayama
- Tohoku University School of Medicine, Sendai, Japan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Murayama A. Re: David-Dan Nguyen, Liam Murad, Anne Xuan-Lan Nguyen, et al. Industry Payments to American Editorial Board Members of Major Urology Journals. Eur Urol. 2023;84:442-43. Eur Urol 2023; 84:e138-e139. [PMID: 37689512 DOI: 10.1016/j.eururo.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 07/09/2023] [Accepted: 07/26/2023] [Indexed: 09/11/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Japan.
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18
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Supakul S, Yoshida M, Kosaka M, Murayama A, Tani Y, Bhandari D, Ozaki A, Tanimoto T. Characteristics of Vulnerable Foreigners in Need of Emergency Care Support in Japan: A Case Study of Thai Nationals from 2004 to 2020. J Immigr Minor Health 2023:10.1007/s10903-023-01566-2. [PMID: 37982918 DOI: 10.1007/s10903-023-01566-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/21/2023]
Abstract
In Japan, a considerable number of foreigners encounter challenges in accessing appropriate healthcare services due to the lack of insurance coverage. However, the absence of a public database on these individuals makes it difficult to assess their health problems and healthcare access status. This study aims to investigate the characteristics of vulnerable Thai patients in Japan and to shed light on the specific challenges they face within Japan's healthcare system. A retrospective analysis was conducted using records of patients who required emergency healthcare support from the Royal Thai Embassy in Tokyo between 2004 and 2020. Descriptive statistical analyses were performed to examine the general characteristics, insurance status, and diseases of the patients. Additionally, patients were classified as either prolonged residents or brief residents based on their duration of stay in Japan until hospital admission (1 year or more or less than 1 year). A total of 74 patients were identified, with the majority (91.9%) lacking insurance coverage. Notably, there was an increase in the number of brief residents, including tourists, during the 2010s. Prolonged residents were more likely to experience chronic diseases, whereas brief residents were more prone to sustaining injuries. The patient records from the Thai Embassy consistently highlight the urgent requirement for emergency healthcare support within this population. However, the existing policies in Japan fall short in adequately addressing the healthcare access needs of this vulnerable population. Therefore, it is crucial to provide additional support and interventions to enhance their healthcare access.
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Affiliation(s)
- Sopak Supakul
- Graduate School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan.
| | - Makoto Yoshida
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
| | - Makoto Kosaka
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
| | - Anju Murayama
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
| | - Yuta Tani
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
| | - Divya Bhandari
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, 2-12-13-201 Takanawa, Minato-ku, Tokyo, Japan
- Navitas Clinic, Tokyo, Japan
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Kawakami H, Ozaki A, Kaneda Y, Asano S, Inai K, Hirooka S, Katoono A, Takagi R, Kosaka M, Murayama A, Sawano T, Shimamura Y, Tsubokura M, Kurokawa T, Tachibana K, Wada M, Tanimoto T, Ohtake T, Kitamura N, Ejiri T, Magome H, Shimmura H, Kanzaki N. Telepathology in intraoperative frozen section consultation of breast cancer sentinel node biopsy in Fukushima, Japan following the 2011 triple disaster: diagnostic accuracy and required time during the early implementation phase. Rural Remote Health 2023; 23:8496. [PMID: 37933099 DOI: 10.22605/rrh8496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
In breast cancer surgery, some medical facilities lack the necessary resources to conduct sentinel lymph node biopsy and its intraoperative frozen section consultation. In the coastal rural area of Fukushima, Japan, which has suffered from physician undersupply following the 2011 triple disaster of earthquake, tsunami and nuclear disaster, we explored the feasibility of telepathology by evaluating the diagnostic accuracy in remote intraoperative frozen section consultation of sentinel lymph node biopsy and its required time. Although examination time has room for improvement, telepathology can be one possible solution in resource-limited areas.
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Affiliation(s)
- Hiroaki Kawakami
- Department of Clinical Examination, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan; Department of Gastrointestinal Surgery, Fukushima Medical University, Fukushima City, Fukushima, Japan; and MNES Inc., Hiroshima City, Hiroshima, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Shigeyuki Asano
- Pathology Center, Iwaki Medical Center, Iwaki City, Fukushima, Japan
| | - Kouki Inai
- Department of Pathology, MNES Inc., Hiroshima City, Hiroshima, Japan
| | - Shinichi Hirooka
- Department of Pathology, Jikei University School of Medicine, Minato City, Tokyo, Japan
| | - Ayumi Katoono
- Department of Clinical Examination, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Riko Takagi
- Department of Clinical Examination, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Makoto Kosaka
- Clinical Training Center, Imamura General Hospital, Kagoshima City, Kagoshima, Japan
| | - Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan; and Department of Radiation Health Management, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Yasuteru Shimamura
- Medical Professional Service, MNES Inc., Hiroshima City, Hiroshima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Tomohiro Kurokawa
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
| | - Kaznoshin Tachibana
- Department of Breast Surgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Masahiro Wada
- Department of Breast Surgery, Utsunomiya Central Clinic, Utsunomiya City, Tochigi, Japan; and Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan; and MNES Inc., Hiroshima City, Hiroshima, Japan
| | - Tohru Ohtake
- Department of Breast Surgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | | | - Tomozo Ejiri
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
| | - Hideyuki Magome
- Department of Clinical Examination, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Hiroaki Shimmura
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Norio Kanzaki
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
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Murayama A. Industry-Sponsored Research Funding to Rheumatologists in the United States Between 2014 and 2022. J Rheumatol 2023; 50:1510-1513. [PMID: 37582555 DOI: 10.3899/jrheum.2023-0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan.
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Murayama A. Nine-Year Analysis of Industry Payments to Geriatricians in the United States Between 2014 and 2022. J Am Med Dir Assoc 2023:104840. [PMID: 37918817 DOI: 10.1016/j.jamda.2023.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES Financial interactions between physicians and the health care industry might create potential conflicts of interest among physicians. However, little is known about the financial relationships between geriatricians and the health care industry. This study aimed to explore the whole picture of geriatricians-industry financial relationships in the United States. DESIGN Cross-sectional analysis using the Open Payments Database from 2014 to 2022. SETTING AND PARTICIPANTS All geriatricians and geriatric psychiatrists in the United States, identified from the National Plan and Provider Enumeration System database. METHODS This study assessed the extent of geriatrician-industry financial relationships in the United States, using the 2014-2022 Open Payments Database. Descriptive analysis was performed on the payment data. Payment trends were examined by interrupted time series analysis with generalized estimating equation models. RESULTS Of 6688 physicians specializing in geriatric medicine or geriatric psychiatry, 4089 (61.1%) received 1 or more payments from the health care industry, totaling $249.6 million between 2014 and 2022. Even though 61.5% to 80.2% of geriatricians did not receive general payments each year, 4078 geriatricians (61.0%) received 1 or more general payments during the 9-year period. Median annual per-geriatrician general payment ranged from $116 to $199 in inflation-adjusted value. The top 1% and 5% of geriatricians received 62.4% ($18.2 million) and 82.2% ($24.0 million) of overall general payments, respectively; 88.3% of all industry payments were distributed for research purposes, but only 1.4% and 2.6% of all geriatricians received direct and associated research payments, respectively. The number of geriatricians receiving payments significantly decreased by 4.2% (95% CI, -4.8 to -3.6; P < .001) in general payments and 4.8% (95% CI, -9.8 to -0.6; P = .03) in associated research between 2014 and 2019. CONCLUSIONS AND IMPLICATIONS More than 60% of geriatricians received at least 1 payment between 2014 and 2022. Although most payments were made for research purposes, both general and research payments have been concentrated on the small number of geriatricians.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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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: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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23
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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. Industry-sponsored research funding to infectious disease physicians in the United States between 2013 and 2021. Clin Microbiol Infect 2023; 29:1348-1350. [PMID: 37423429 DOI: 10.1016/j.cmi.2023.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/22/2023] [Accepted: 07/02/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan.
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Shimmura H, Banno T, Nakamura K, Murayama A, Shigeta H, Sawano T, Kouchi Y, Ozaki A, Yamabe F, Iizuka J, Takagi T. A single-center retrospective comparative analysis of urinary continence in robotic prostatectomy with a combination of umbilical ligament preservation and Hood technique. Int J Urol 2023; 30:889-895. [PMID: 37345368 DOI: 10.1111/iju.15227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVES Data available on the effect of the recently developed Hood technique and its modified iterations in robot-assisted radical prostatectomy on postoperative urinary continence are insufficient. We evaluated the time to achieve urinary continence with the modified Hood technique compared with the standard or umbilical ligament preservation robot-assisted radical prostatectomy. METHODS This retrospective analysis examines patient records for those who underwent robot-assisted radical prostatectomy at the Jyoban Hospital of Tokiwa Foundation in Fukushima, Japan, from 2017 to 2021. The main outcome was to determine significant differences in the time taken to achieve urinary continence among the three procedure types. We employed the Kaplan-Meier survival analysis to estimate the time to achieve urinary continence in the three procedure types of robot-assisted radical prostatectomy. Additionally, we used a Cox regression hazard model to evaluate the association between the time to achieve urinary continence and the procedure types. RESULTS We considered 196 patients in this study. The estimated rates of achieving urinary continence at 6 months following standard, umbilical ligament preservation, and modified Hood technique robot-assisted radical prostatectomy were 77.6%, 89.5%, and 100%, respectively. The multivariable Cox hazard regression model showed that patients who underwent the modified Hood technique were significantly more likely to achieve urinary continence than those who underwent the standard robot-assisted radical prostatectomy. CONCLUSIONS The modified Hood technique achieved better urinary continence outcomes, with all patients with the procedure achieving urinary continence at 6 months. Further randomized controlled trials are required to validate this finding.
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Affiliation(s)
- Hiroaki Shimmura
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Taro Banno
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Kazutaka Nakamura
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Anju Murayama
- Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Haruki Shigeta
- Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yukiko Kouchi
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
- Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan
| | - Fumito Yamabe
- Department of Urology, Toho University Omori Medical Center, Tokyo, Japan
| | - Junpei Iizuka
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshio Takagi
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
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Murayama A, Saito H, Tanimoto T, Ozaki A. Financial conflicts of interest between pharmaceutical companies and executive board members of internal medicine subspecialty societies in Japan between 2016 and 2020. J Eval Clin Pract 2023; 29:883-886. [PMID: 37283452 DOI: 10.1111/jep.13877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023]
Abstract
RATIONALE Pharmaceutical companies make payments to physicians such as compensations for lecturing or consulting. Of particular, financial relationships between pharmaceutical companies and leaders of professional medical societies are concern in medical community. However, little was known about them in Japan. AIMS AND OBJECTIVES This study aimed to evaluate the magnitude and prevalence of personal payments to executive board members (EBMs) of 15 medical associations representing different subspecialties within the Japanese Society of Internal Medicine. METHOD All EBMs of 15 medical associations representing internal medicine subspecialties were collected from each association webpage. Payments to the EBMs were extracted from the pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association between 2016 and 2020. We performed descriptive analysis on the payment data. RESULTS Of the 353 different EBMs identified, 350 (99.2%) received one or more personal payments from the pharmaceutical companies over the 5 years. 99.2% (350) and 97.2% (343) of all EBMs received personal payments 3 years before and in the year of their board membership. A total of $70,796,014 were made to the EBMs over the 5 years. The median 5-year combined personal payments per EBM was $150,849 (interquartile range [IQR]: $73,412-$282,456). EBMs who were chairman or vice chairman of executive board received significantly larger median personal payments than those who were not ($225,685 vs. $143,885, p = 0.01 in the U test). Among the 15 societies, there were 12 (80.0%) societies with all (100%) EBMs receiving personal payments from the pharmaceutical companies. Although every society has their own conflicts of interest policy, none publicly discloses the financial relationships between pharmaceutical companies and their EBMs due to their privacy. CONCLUSION This study demonstrated that nearly all EBMs of 15 medical associations representing internal medicine subspecialties had substantial financial relationships with the pharmaceutical companies in Japan over the past 5 years.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Internal Medicine, Navitas Clinic Tachikawa, Tachikawa, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki, Fukushima, Japan
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Murayama A. Industry-sponsored research funding to allergists and clinical immunologists in the United States. Ann Allergy Asthma Immunol 2023; 131:395-397. [PMID: 37353050 DOI: 10.1016/j.anai.2023.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan.
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Murayama A, Kugo H, Saito Y, Saito H, Tanimoto T, Ozaki A. A 9-Year Investigation of Healthcare Industry Payments to Pulmonologists in the United States. Ann Am Thorac Soc 2023; 20:1283-1292. [PMID: 36961514 DOI: 10.1513/annalsats.202209-827oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/24/2023] [Indexed: 03/25/2023] Open
Abstract
Rationale: The healthcare industry sometimes makes payments to physicians for nonresearch and research purposes in the United States. Objectives: We aimed to evaluate the trends in nonresearch and research industry payments to pulmonologists since the inception of the Open Payments database in 2013. Methods: Using the Open Payments database between August 2013 and December 2021, this population-based observational cohort study examined nonresearch and research payments made by the healthcare industry to pulmonologists registered in the National Plan and Provider Enumeration System in the United States. We performed descriptive analyses on payment data and generalized estimating equations for payment trends. Results: Of 12,488 active pulmonologists, 11,074 (88.7%) accepted a total of 2,246,412 payments totaling $1,053,344,669. Total payments were $253,405,965 (24.1%) in nonresearch, $17,382,904 (1.7%) in direct research, and $782,555,800 (74.3%) in associated research payments between 2013 and 2021. Median per-physician payments (interquartile range) were $2,342 ($496 to $8,299) for nonresearch, $4,688 ($1,435 to $21,803) for direct research, and $95,927 ($20,300 to $344,995) for associated research payments. The top 1%, 5%, and 10% of pulmonologists accepted 37.3%, 71.9%, and 83.7% of the total nonresearch payments. The per-physician nonresearch payments increased by 2.9% (95% confidence interval [CI], 1.2 to 4.7; P = 0.001) annually between 2014 and 2019 and decreased by 50.2% (95% CI, -55.3 to -44.6; P < 0.001) in 2020, whereas there was no yearly change in research payments. Conclusions: Nearly 90% of pulmonologists received nonresearch and research payments from the healthcare industry in the United States. Nonresearch payments have been increasing since the inception of the Open Payments database.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Japan
| | - Hinari Kugo
- School of Medicine, Tohoku University, Sendai, Japan
| | - Yoshika Saito
- Medical Governance Research Institute, Minato-ku, Japan
- Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Japan
- Department of Internal Medicine, Soma Central Hospital, Soma, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Japan
- Department of Internal Medicine, Navitas Clinic Tachikawa, Tachikawa, Japan; and
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki, Japan
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Murayama A. Pharmaceutical industry-sponsored meals and prescriptions of biologics for asthma. J Allergy Clin Immunol Pract 2023; 11:2916-2918. [PMID: 37245733 DOI: 10.1016/j.jaip.2023.05.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai City, Miyagi, Japan.
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Murayama A, Kamamoto S, Saito H, Yamashita E, Suzuki Y, Tanimoto T, Ozieranski P, Ozaki A. Characteristics and Distribution of Scholarship Donations From Pharmaceutical Companies to Japanese Healthcare Institutions in 2017: A Cross-sectional Analysis. Int J Health Policy Manag 2023; 12:7621. [PMID: 38618821 PMCID: PMC10590253 DOI: 10.34172/ijhpm.2023.7621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 07/31/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Financial relationships between healthcare institutions and pharmaceutical companies can lead to conflicts of interest (COIs), potentially compromising patients' care. In Japan, scholarship donations, unique type of payments made to healthcare institutions and their subunits by pharmaceutical industries without restricting their use including non-educational or research purpose, may often have implicit promotional purposes. However, detailed information about these payments remains scarce. METHODS This study employed a cross-sectional design to analyse the extent and distribution of all scholarship donations made by all 73 pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association (JPMA) to healthcare institutions in 2017. Data were obtained from publicly available sources from the companies, and the total number of payments, their distributions across various institutions and specialties were analysed. RESULTS A total of 27 007 payment contracts amounting to $178 703 721 in scholarship donations were made to 4839 specific departments and laboratories at 251 different institutions by 67 pharmaceutical companies. National universities received 50.8% of total payments. All universities setting medical school in Japan received one or more payments. Domestic pharmaceutical companies contributed to $137 797 302 (77.1%) in total. Clinical medicine departments received 89.6% ($160 113 147) with 6.2% ($11 011 946) and 2.0% ($3 600 456) allocated to basic medicine and social medicine specialties, respectively. CONCLUSION This study provided a comprehensive overview of scholarship donations from pharmaceutical companies to healthcare institutions in Japan, revealing significant financial support primarily directed to national universities and clinical medicine departments. Japanese policy-makers should consider implementing regulations that promote transparency and mitigate potential COIs arising from scholarship donations, which may be useful in other countries with similar schemes.
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Affiliation(s)
| | - Sae Kamamoto
- Medical Governance Research Institute, Tokyo, Japan
| | - Hiroaki Saito
- Department of Internal Medicine, Soma Central Hospital, Soma, Japan
| | | | | | - Tetsuya Tanimoto
- Medical Governance Research Institute, Tokyo, Japan
- Department of Internal Medicine, Navitas Clinic Kawasaki, Kawasaki, Japan
| | - Piotr Ozieranski
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
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Abstract
Although proper physician-industry financial relationships are essential for improving patient care, they can also cause potential conflicts of interest. However, little is known about the pathologist-industry financial relationships. Using the 2013-2021 Open Payments Database, this cross-sectional study investigated both research and non-research payments to all pathologists in the USA. Payment data were analyzed descriptively. Of 21,664 pathologists, 49.5% of all pathologists have received payments totaling $356.7 million from the healthcare industry, of which 68.2% were research payments. Median per-physician general and associated research payments (IQR) were $145($49-$575) and $70,926 ($17,450-$299,285) over the nine years. The top 1% of pathologists receiving general payments received 68.0% of all general payments. Male pathologists specializing in blood banking and transfusion medicine and hematopathology are significantly more likely than those not to receive research and non-research payments. This first study provides valuable insights into the financial relationships between pathologists and the healthcare industry.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Shuto Hirota
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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Kamamoto S, Ozaki A, Murayama A. Assessment of Financial Relationships Between Otorhinolaryngologists and Pharmaceutical Companies in Japan Between 2016 and 2019. Cureus 2023; 15:e43633. [PMID: 37719565 PMCID: PMC10503947 DOI: 10.7759/cureus.43633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION There are prevalent financial relationships between physicians and the pharmaceutical industry in medical specialties, including otorhinolaryngology. Although these relationships might cause conflicts of interest, no studies have assessed the size and contents of the financial relationships between otorhinolaryngologists and pharmaceutical companies in Japan. This study aims to evaluate the magnitude, prevalence, and trend of the financial relationship between Japanese otolaryngologists and pharmaceutical companies. METHODS Using payment data publicly disclosed by 92 pharmaceutical companies, we examined the size, prevalence, and trend in personal payments made to the otorhinolaryngologist board certified by the Japanese Society of Otorhinolaryngology-Head and Neck Surgery (JSO-HNS) between 2016 and 2019 in Japan. Furthermore, differences in payments were evaluated by whether otolaryngologists were clinical practice guideline authors, society board members, and academic journal editors or not. Trends in payments were evaluated by generalized estimating equations. RESULTS Of 8,190 otorhinolaryngologists, 3,667 (44.8%) were paid a total of $13,873,562, in payments for lecturing, consulting, and writing by 72 pharmaceutical companies between 2016 and 2019. The median four-year combined payment per physician was $1,022 (interquartile range: $473-$2,526). Top 1%, 5%, and 10% of otorhinolaryngologists received 42.3% (95% confidence interval (95% CI): 37.2%-47.4%), 69.3% (95% CI: 65.9%-72.8%), and 80.6% (95% CI: 78.3%-82.9%) of overall payments, respectively. The median payments per physician were significantly higher among otorhinolaryngologists authoring clinical practice guidelines ($11,522), society board members ($22,261), and journal editors ($35,143) than those without. The payments and number of otorhinolaryngologists receiving payments remained stable between 2016 and 2019. CONCLUSION This study demonstrates that a minority but a large number of otorhinolaryngologists received personal payments from pharmaceutical companies for the reimbursement of lecturing, consulting, and writing in Japan. Large amounts of these personal payments were significantly concentrated on a small number of leading otorhinolaryngologists.
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Affiliation(s)
- Sae Kamamoto
- School of Medicine, Hamamatsu University, Hamamatsu, JPN
| | - Akihiko Ozaki
- Surgery, Teikyo University Graduate School of Public Health, Tokyo, JPN
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Kosaka M, Ozaki A, Kaneda Y, Saito H, Yamashita E, Murayama A, Mamada H, Tanimoto T, Jakovljevic M. Generic drug crisis in Japan and changes leading to the collapse of universal health insurance established in 1961: the case of Kobayashi Kako Co. Ltd. Cost Eff Resour Alloc 2023; 21:35. [PMID: 37259132 DOI: 10.1186/s12962-023-00441-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Breast and Thryoid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Anju Murayama
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Hanano Mamada
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | | | - Mihajlo Jakovljevic
- Institute of Advanced Manufacturing Technologies, Peter the Great St. Petersburg Polytechnic University, St. Petersburg, Russia.
- Institute of Comparative Economic Studies, Hosei University, Chiyoda-ku, Tokyo, Japan.
- Department of Global Health Economics and Policy, University of Kragujevac, Kragujevac, Serbia.
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Murayama A, Kamamoto S, Saito H, Ozaki A. Pharmaceutical payments to Japanese board-certified dermatologists: a 4-year retrospective analysis of personal payments from pharmaceutical companies between 2016 and 2019. Sci Rep 2023; 13:7425. [PMID: 37156855 PMCID: PMC10167352 DOI: 10.1038/s41598-023-34705-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
There are prevalent financial relationships between dermatologists and pharmaceutical companies in Japan. However, little was known about the extent of whole picture of the personal payments made to dermatologists by pharmaceutical companies. This study aimed to examine the personal payments to the board-certified dermatologists by the Japanese Dermatological Association from the pharmaceutical companies between 2016 and 2019. Using the publicly disclosed payments data by the pharmaceutical companies between 2016 and 2019, we evaluated the magnitude, prevalence, and trends in the personal payments made to all board-certified dermatologists for the lecturing, writing, and consulting compensations. The payments were descriptively analyzed overall and by dermatologist demographics. Additionally, the payment trends were assessed by generalized estimating equation models. Of 6883 active board-certified dermatologists, 3121 (45.3%) received a total of $33,223,806 personal payments between 2016 and 2019. The median per-physician payments and number of payments (interquartile range) were $1737 ($613-$5287) and 4.0 (2.0-10.0) over the 4 years, respectively. Only top 1%, 5%, 10% of dermatologists received 41.7% (95% confidence interval [CI] 38.2-45.1%), 76.9% (95% CI 74.7-79.1%), and 87.6% (95% CI 86.2-88.9%) of overall payments. The number of dermatologists receiving payments and per-dermatologist payments increased by 4.3% (95% CI 3.1‒5.5%, p < 0.001) and 16.4% (95% CI 13.5‒19.4%, p < 0.001) each year. The board-certification in dermatology-oncology, in cosmetic dermatology, and male sex were significantly associated with higher personal payments with relative monetary values of 2.29 (95% CI 1.65-3.19, p < 0.001), 3.16 (95% CI 1.89-5.26, p < 0.001), and 5.38 (95% CI 4.12-7.04, p < 0.001). Less than half of Japanese board-certified dermatologists received lower personal payments from the pharmaceutical companies than those to other specialists. However, these personal payments were increasingly more prevalent and greater over the 4 years.
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Affiliation(s)
- Anju Murayama
- Tohoku University School of Medicine, Sendai, Miyagi, Japan.
| | - Sae Kamamoto
- Faculty of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - Akihiko Ozaki
- Faculty of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
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Murayama A, Kamamoto S, Kawashima M, Saito H, Yamashita E, Tanimoto T, Ozaki A. Cross-sectional analysis of pharmaceutical payments to Japanese board-certified gastroenterologists between 2016 and 2019. BMJ Open 2023; 13:e068237. [PMID: 37072354 PMCID: PMC10124293 DOI: 10.1136/bmjopen-2022-068237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVES Limited evidence is available regarding the financial relationships between gastroenterologists and pharmaceutical companies in Japan. This study analysed the magnitude, prevalence and trends of personal payments made by major pharmaceutical companies to board-certified gastroenterologists in Japan in recent years. DESIGN Cross-sectional analysis SETTING AND PARTICIPANTS: Using payment data publicly disclosed by 92 major pharmaceutical companies, this study examined the non-research payments made to all board-certified gastroenterologists by the Japanese Society of Gastroenterology. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were payment amounts, the prevalence of gastroenterologists receiving payments, yearly trends in per-gastroenterologist payment values and the number of gastroenterologists with payments. Additionally, we evaluated the differences in payments among influential gastroenterologists, including clinical practice guideline authors, society board member gastroenterologists and other general gastroenterologists. RESULTS Approximately 52.8% of all board-certified gastroenterologists received a total of US$89 151 253, entailing 134 249 payment contracts as the reimbursement for lecturing, consulting and writing, from 84 pharmaceutical companies between 2016 and 2019. The average and median payments per gastroenterologist were US$7670 (SD: US$26 842) and US$1533 (IQR: US$582-US$4781), respectively. The payment value per gastroenterologist did not significantly change during the study period, while the number of gastroenterologists with payments decreased by -1.01% (95% CI: -1.61% to -0.40%, p<0.001) annually. Board member gastroenterologists (median: US$132 777) and the guideline authoring gastroenterologists (median: US$106 069) received 29.9 times and 17.3 times higher payments, respectively, than general gastroenterologists (median: US$284). CONCLUSION Most gastroenterologists received personal payments from pharmaceutical companies, but only very few influential gastroenterologists with authority accepted substantial amounts in Japan. There should be transparent and rigorous management strategies for financial conflicts of interest among gastroenterologists working in influential positions.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Sae Kamamoto
- School of Medicine, Hamamatsu University, Hamamatsu, Japan
| | - Moe Kawashima
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Internal Medicine, Soma Central Hospital, Soma, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Internal Medicine, Jyoban Hospital, Iwaki, Fukushima, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Joban Hospital, Iwaki, Fukushima, Japan
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Murayama A, Kamamoto S, Saito H, Tanimoto T, Ozaki A. Research and Nonresearch Industry Payments for COVID-19 mRNA Vaccines in the United States. JMA J 2023; 6:201-203. [PMID: 37179719 PMCID: PMC10169267 DOI: 10.31662/jmaj.2022-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/12/2023] [Indexed: 05/15/2023] Open
Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Tokyo, Japan
- Tohoku University School of Medicine, Sendai, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Tokyo, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Navitas Clinic Tachikawa, Tokyo, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
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Murayama A, Mamada H, Shigeta H, Yoshinaga T, Saito H, Yamashita E, Tanimoto T, Ozaki A. Financial Relationships Between Pharmaceutical Companies and Rheumatologists in Japan Between 2016 and 2019. J Clin Rheumatol 2023; 29:118-125. [PMID: 36729793 DOI: 10.1097/rhu.0000000000001922] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUNDS Given the increasing number of novel and expensive drugs for rheumatoid diseases, the financial relationships between pharmaceutical companies and rheumatologists could be prevalent and substantial. However, little was known about the information in Japan. METHODS Using payment data publicly disclosed by 92 major pharmaceutical companies, we evaluated the financial relationships between pharmaceutical companies and rheumatologists who were board certified by the Japan College of Rheumatology between 2016 and 2019. The trends in payments were estimated by the generalized estimating equations with 4-year payment data. Differences in payments between general and leading rheumatologists including the board members, clinical practice guideline authors, and medical journal editors were assessed. RESULTS Of the board-certified rheumatologists, 70.7% (3563 of 5038) received a total of $55,246,485 in personal payments for lecturing, writing, and consulting from 79 pharmaceutical companies between 2016 and 2019. The median payments per rheumatologist receiving payments were $3447 (interquartile range, $1124-$11,974) in payment amounts. There were increasing trends in the payments per rheumatologist and the number of rheumatologists with payments, with average yearly change rates of 5.9% (95% confidence interval, 3.9%-7.9%; p < 0.001) and 1.2% (95% CI, 0.3%-2.0%; p = 0.008). The leading rheumatologists such as the society board members, clinical practice guideline authors, and medical journal editors received much more payments than other rheumatologists. CONCLUSION Most rheumatologists increasingly received personal payments for lecturing, consulting, and writing reimbursements from pharmaceutical companies in Japan. These payments were significantly concentrated on rheumatologists in authoritative and influential positions.
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Suzuki T, Murayama A, Kotera Y, Bhandari D, Senoo Y, Tani Y, Harada K, Kawamoto A, Sato S, Sawano T, Miyata Y, Tsubokura M, Tanimoto T, Ozaki A. Correction: Suzuki et al. Cross-Country Student Perceptions about Online Medical Education during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 2840. Int J Environ Res Public Health 2023; 20:5330. [PMID: 37048043 PMCID: PMC10075280 DOI: 10.3390/ijerph20075330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/11/2023] [Indexed: 06/19/2023]
Abstract
In the published publication, there was an error regarding the affiliation for "Tomoya Suzuki" [...].
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Affiliation(s)
- Tomoya Suzuki
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
- School of Medicine, Akita University, 1-1-1 Hondo, Akita 0108543, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
| | - Divya Bhandari
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Yuki Senoo
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Yuta Tani
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Kayo Harada
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Ayumu Kawamoto
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Satomi Sato
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 9728322, Japan
| | - Yasushi Miyata
- Department of Primary Care and Community Health, Aichi Medical University, Nagakute 4801195, Japan
| | - Masaharu Tsubokura
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima 9601247, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
- Department of Internal Medicine, Navitas Clinic Kaswasaki, Kawasaki 2100007, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Takanawa, Minato-ku, Tokyo 1087505, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 9728322, Japan
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Shigeta H, Murayama A, Kamamoto S, Saito H, Ozaki A. Evaluation of Financial Conflicts of Interest and Quality of Evidence Underlying the American Diabetes Association Clinical Practice Guidelines: The Standards of Medical Care in Diabetes, 2021. Cureus 2023; 15:e36567. [PMID: 37095789 PMCID: PMC10122171 DOI: 10.7759/cureus.36567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Clinical practice guidelines make recommendations based on the best available evidence. Proper management and disclosure of financial conflicts of interest (FCOIs) are necessary for trustworthy clinical practice guidelines. This study evaluated the prevalence of FCOIs and quality of evidence underlying the American Diabetes Association (ADA) guidelines. METHODS Using the Open Payments Database (OPD) between 2018 and 2020, we examined the research and general payments to all authors of the Standards of Medical Care in Diabetes, 2021. The quality of evidence and tone of recommendations were assessed and the associations between the two were evaluated by logistic regression analysis. RESULTS Of the 25 guideline authors, 15 (60.0%) were United States (US)-based physicians eligible for the OPD search. Eight (32.0%) and 12 (48.0%) received one or more industry payments one year and three years prior to the guideline publication, respectively. The median total payments (interquartile range) per author were $33,262 ($4,638‒$101,271) in 2020 and $18,053 ($2,529‒$220,659) in 2018-2020. One author received a research payment of over $10,000 undeclared. Of 471 recommendations, 61 (13.0%) and 97 (20.6%) were supported by low-quality evidence and expert opinions, respectively. Also, 439 (93.2%) recommendations had a positive tone. The lower quality of evidence tended to recommend positively with an odds ratio of 1.56 (95% confidence interval: 0.96-2.56, p=0.075) without reaching statistical significance. CONCLUSION A minority of the guideline authors received industry payments from the healthcare industry, and declared FCOIs were mostly accurate. However, the ADA FCOI policy required the guideline authors to declare their FCOIs for one year before publication. A more transparent and rigorous FCOI policy is needed in the ADA guidelines.
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Affiliation(s)
| | | | - Sae Kamamoto
- School of Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN
| | | | - Akihiko Ozaki
- Surgery, Teikyo University Graduate School of Public Health, Tokyo, JPN
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Kasai T, Banno T, Nakamura K, Kouchi Y, Shigeta H, Suzuki F, Kaneda Y, Bhandari D, Murayama A, Takamatsu K, Kobayashi N, Sawano T, Nishikawa Y, Sato H, Ozaki A, Kurokawa T, Kanzaki N, Shimmura H. Duration and Influencing Factors of Postoperative Urinary Incontinence after Robot-Assisted Radical Prostatectomy in a Japanese Community Hospital: A Single-Center Retrospective Cohort Study. Int J Environ Res Public Health 2023; 20:4085. [PMID: 36901096 PMCID: PMC10001515 DOI: 10.3390/ijerph20054085] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Post-operative urinary incontinence (PUI) after robotic-assisted radical prostatectomy (RARP) is an important complication; PUI occurs immediately after postoperative urethral catheter removal, and, although approximately 90% of patients improve within one year after surgery, it can significantly worsen their quality of life. However, information is lacking on its nature in community hospital settings, particularly in Asian countries. The purposes of this study were to investigate the time required to recover from PUI after RARP and to identify its associated factors in a Japanese community hospital. METHODS Data were extracted from the medical records of 214 men with prostate cancer who underwent RARP from 2019 to 2021. We then calculated the number of days elapsed from the surgery to the initial outpatient visit confirming PUI recovery among the patients. We estimated the PUI recovery rate using the Kaplan-Meier product limit method and evaluated associated factors using the multivariable Cox proportional hazards model. RESULTS The PUI recovery rates were 5.7%, 23.4%, 64.6%, and 93.3% at 30, 90, 180, and 365 days following RARP, respectively. After an adjustment, those with preoperative urinary incontinence experienced significantly slower PUI recovery than their counterparts, while those with bilateral nerve sparing experienced recovery significantly sooner than those with no nerve sparing. CONCLUSION Most PUI improved within one year, but a proportion of those experiencing recovery before 90 days was smaller than previously reported.
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Affiliation(s)
- Tadashi Kasai
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Taro Banno
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Kazutaka Nakamura
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Yukiko Kouchi
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Haruki Shigeta
- School of Medicine, Tohoku University, Sendai 980-8575, Japan
| | - Fumio Suzuki
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Divya Bhandari
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
- Medical Governance Research Institute, Tokyo 108-0074, Japan
| | - Anju Murayama
- School of Medicine, Tohoku University, Sendai 980-8575, Japan
| | - Katumori Takamatsu
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Naomi Kobayashi
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Yoshitaka Nishikawa
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan
| | - Hiroyuki Sato
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
- Medical Governance Research Institute, Tokyo 108-0074, Japan
| | - Tomohiro Kurokawa
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Norio Kanzaki
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
| | - Hiroaki Shimmura
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
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Ozaki A, Harada K, Murayama A, Saito H, Sawano T, Tanimoto T, Shrestha S, Bhandari D, Crump A. Japan's valsartan clinical trials shambles; time for fundamental changes. Int J Health Plann Manage 2023; 38:557-568. [PMID: 36794862 DOI: 10.1002/hpm.3618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/27/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Japan's Diovan® /valsartan 'scandal' has received sensational coverage in the nation's media since 2012. Publication of fraudulent research and their subsequent retraction boosted and then curtailed the use of what was a useful therapeutic drug. Some authors of the papers resigned, others disputed the retractions and resorted to legal counsel to protect themselves. One individual, an undeclared Novartis employee involved in the research, was arrested. A complex and virtually unwinnable case was brought against him and Novartis, claiming that data alteration amounted to false advertising, but lengthy criminal court cases resulted in the case failing. Unfortunately, key elements, including conflicts of interest, pharmaceutical company interference in trials of its product, and the role of the institutions involved, have been effectively ignored. The incident also emphasised the fact that Japan's unique society and approach to science does not conform well to international standards. Although the supposed impropriety caused the appearance of a new Clinical Trials Act in 2018, the law has been criticized for being ineffectual and simply increasing clinical trial bureaucracy. This article examines the 'scandal' and identifies where changes must be made to clinical research and the roles of the various stakeholders in Japan to increase public trust in clinical trials and biomedical publications.
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Affiliation(s)
- Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Iwaki, Japan
| | - Kayo Harada
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | | | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Divya Bhandari
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Andy Crump
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
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Murayama A, Saito H, Kamamoto S, Shigeta H, Yamashita E, Tanimoto T, Ozaki A. Evaluation of non-research payments from pharmaceutical companies to urologists in Japan between 2016 and 2019. Int Urogynecol J 2023:10.1007/s00192-023-05463-y. [PMID: 36723634 DOI: 10.1007/s00192-023-05463-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/02/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the magnitude and trends in personal payments from pharmaceutical companies to urologists in Japan. METHODS This cross-sectional study examined the personal payments made to urologists by the major pharmaceutical companies in Japan between 2016 and 2019. Descriptive analyses were performed on the payment data. All urologists board-certified by the Japanese Urological Association as of March 2022 were included in this study. Trends in personal payments were assessed using the population-averaged generalized estimating equations with panel data of per-physician personal payments. RESULTS Among 7016 active board-certified urologists, 4962 (70.7%) accepted 53,070 payments totaling $36,424,239 for reimbursement of lecturing, writing, and consulting compensations from 66 pharmaceutical companies between 2016 and 2019. The median payments per urologist receiving payments were $1714 [interquartile range(IQR): $700-$4583] in payment amounts and 4.0 (IQR: 2.0-10.0) in the number of payments. Only 1%, 5%, 10%, and 25% of top-paid urologists accepted 36.2%, 64.8%, 75.8%, and 90.1% of overall payments respectively. The payments per urologist and the number of payment contracts had annually increased over this period by 4.1% (95% CI: 2.3%-6.0%, p < 0.001) and 2.4% (95% CI: 1.2%-3.7%, p < 0.001), but there was no significant change in the number of urologists receiving payments, with a relative average annual change of 0.7% (95% CI: -0.15%-1.6%, p = 0.10) between 2016 and 2019. CONCLUSION Most urologists received personal payments for lecturing, consulting, and writing compensations from pharmaceutical companies in Japan. The payments from pharmaceutical companies had been increasing over the 4-year period. These payments were substantially concentrated on a small number of urologists.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan. .,Tohoku University School of Medicine, 2-1 Seiryo Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan.
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan.,Department of Internal Medicine, Soma Central Hospital, Soma City , Fukushima, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan.,Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan
| | - Haruki Shigeta
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan.,Tohoku University School of Medicine, 2-1 Seiryo Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan.,Department of Internal Medicine, Navitas Clinic Kawasaki, Kawasaki City, Kanagawa,, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-Ku, Tokyo, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
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Mamada H, Murayama A, Ozaki A, Hashimoto T, Saito H, Sawano T, Yamashita E, Bhandari D, Shrestha S, Tanimoto T. Observational study of financial and non-financial conflicts of interest among the Japanese government advisory board members concerning coronavirus disease 2019. Medicine (Baltimore) 2023; 102:e32776. [PMID: 36705373 PMCID: PMC9875957 DOI: 10.1097/md.0000000000032776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This cross-sectional analysis aimed to assess the extent of conflicts of interest among the Japanese government coronavirus disease 2019 (COVID-19) advisory board members and elucidate the accuracy of conflicts of interest (COI) disclosure and management strategies. Using the payment data from all 79 pharmaceutical companies in Japan between 2017 and 2019 and direct research grants from the Japanese government between 2019 and 2020, we evaluated the extent of financial and non-financial COI among all 20 Japanese government COVID-19 advisory board members. The Ethic Committee of the Medical Governance Research Institute approved this study. Japanese government COVID-19 advisory board members were predominantly male (75.0%) and physicians (50.0%). Between 2019 and 2020, 2 members (10.0%) received a total of $819,244 in government research funding. Another 5 members (25.0%) received $532,127 in payments, including $276,722 in personal fees, from 31 pharmaceutical companies between 2017 and 2019. The average value of the pharmaceutical payments was $9155 (standard deviation: $12,975). Furthermore, neither the Ministry of Health, Labor, and Welfare nor the Japanese Cabinet Secretariat disclosed financial or non-financial COI with industry. Additionally, the government had no policies for managing COI among advisory board members. This study found that the Japanese government COVID-19 advisory board had financial and non-financial COI with pharmaceutical companies and the government. Furthermore, personal communication received as part of this research indicated that there were no rigorous COI management strategies for the COVID-19 advisory board members. Any government must ensure the independence of scientific advisory boards by implementing more rigorous and transparent management strategies that require the declaration and public disclosure of all COI.
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Affiliation(s)
- Hanano Mamada
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Akita University School of Medicine, Akita, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Tohoku University School of Medicine, Sendai, Miyagi, Japan
- * Correspondence: Anju Murayama, Tohoku University School of Medicine, Sendai, Miyagi 980-8575, Japan (e-mail: )
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Takanao Hashimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Pharmacy, Sendai City Medical Center, Sendai, Miyagi, Japan
| | - Hiroaki Saito
- Department of Internal medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Divya Bhandari
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Internal Medicine, Navitas Clinic, Kawasaki, Kanagawa, Japan
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Murayama A, Shigeta H, Kamamoto S, Yamashita E, Saito H, Sawano T, Bhandari D, Shrestha S, Kusumi E, Tanimoto T, Ozaki A. Pharmaceutical Payments to Japanese Board‐Certified Head and Neck Surgeons Between 2016 and 2019. OTO Open 2023; 7:e31. [PMID: 36998569 PMCID: PMC10046701 DOI: 10.1002/oto2.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/15/2022] [Accepted: 12/25/2022] [Indexed: 02/19/2023] Open
Abstract
Objective To evaluate the magnitude, prevalence, and trend of the financial relationship between Japanese head and neck surgeons and pharmaceutical companies between 2016 and 2019. Study Design Cross-sectional analysis. Setting Japan. Methods This study evaluated personal payments concerning lecturing, consulting, and writing paid by 92 major pharmaceutical companies to all Japanese head and neck surgeons board-certified by the Japan Society for Head and Neck Surgery between 2016 and 2019. The payments were descriptively analyzed and payment trend were assessed using population-averaged generalized estimating equations. Further, the payments to board executive board members with specialist certification were also evaluated separately. Results Of all 443 board-certified head and neck surgeons in Japan, 365 (82.4%) received an average of $6443 (standard deviation: $12,875), while median payments were $2002 (interquartile ranges [IQR] $792-$4802). Executive board specialists with a voting right received much higher personal payments (median $26,013, IQR $12,747-$35,750) than the non-executive specialists (median $1926, IQR $765‒$4134, p < .001) and the executive board specialists without a voting right (median $4411, IQR $963-$5623, p = .015). The payments per specialist and prevalence of specialists with payments annually increased by 11.4% (95% CI: 5.8%-17.2%; p < .001) and 7.3% (95% CI: 3.8%-11.0%; p < .001), respectively. Conclusion There were increasingly widespread and growing financial relationships with pharmaceutical companies among head and neck surgeons in Japan, alongside of introduction of novel drugs. The leading head and neck surgeons received much higher personal payments from pharmaceutical companies, and no sufficient regulation was implemented by the society in Japan.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- School of Medicine Tohoku University Sendai city Miyagi Japan
| | - Haruki Shigeta
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- School of Medicine Tohoku University Sendai city Miyagi Japan
| | - Sae Kamamoto
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Faculty of Medicine Hamamatsu University School of Medicine Hamamatsu Shizuoka Japan
| | | | - Hiroaki Saito
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Internal Medicine Soma Central Hospital Soma City Fukushima Japan
| | - Toyoaki Sawano
- Department of Surgery Jyoban Hospital of Tokiwa Foundation Iwaki City Fukushima Japan
| | - Divya Bhandari
- Medical Governance Research Institute Minato‐ku Tokyo Japan
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia Jalan Lagoon Selatan Bandar Sunway Jalan Lagoon Selatan Malaysia
| | - Eiji Kusumi
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Internal Medicine Navitas Clinic Shinjuku Shinjuku‐ku Tokyo Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Internal Medicine Navitas Clinic Tachikawa Tachikawa City Tokyo Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Breast and Thyroid Surgery Jyoban Hospital of Tokiwa Foundation Iwaki City Fukushima Japan
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Murayama A, Hoshi M, Saito H, Kamamoto S, Tanaka M, Kawashima M, Mamada H, Kusumi E, Sapkota B, Shrestha S, Shrestha R, Bhandari D, Sawano T, Yamashita E, Tanimoto T, Ozaki A. Nature and Trends in Personal Payments Made to the Respiratory Physicians by Pharmaceutical Companies in Japan between 2016 and 2019. Respiration 2022; 101:1088-1098. [PMID: 36353778 PMCID: PMC9811425 DOI: 10.1159/000526576] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Financial relationships between healthcare professionals and pharmaceutical companies have historically caused conflicts of interest and unduly influenced patient care. However, little was known about such relationship and its effect in clinical practice among specialists in respiratory medicine. METHODS Based on the retrospective analysis of payment data made available by all 92 pharmaceutical companies in Japan, this study evaluated the magnitude and trend of financial relationships between all board-certified Japanese respiratory specialists and pharmaceutical companies between 2016 and 2019. Magnitude and prevalence of payments for specialists were analyzed descriptively. The payment trends were assessed using the generalized estimating equations for the payment per specialist and the number of specialists with payments. RESULTS Among all 7,114 respiratory specialists certified as of August 2021, 4,413 (62.0%) received a total of USD 53,547,391 and 74,195 counts from 72 (78.3%) pharmaceutical companies between 2016 and 2019. The median (interquartile range) 4-year combined payment values per specialist were USD 2,210 (USD 715-8,178). At maximum, one specialist received USD 495,332 personal payments over the 4 years. Both payments per specialist and number of specialists with payments significantly increased during the 4-year period, with 7.8% (95% CI: 5.5-9.8; p < 0.001) in payments and 1.5% (95% CI: 0.61-2.4; p = 0.001) in number of specialists with payments, respectively. CONCLUSION The majority of respiratory specialists had increasingly received more personal payments from pharmaceutical companies for the reimbursement of lecturing, consulting, and writing between 2016 and 2019. These increasing financial relationships with pharmaceutical companies might cause conflicts of interest among respiratory physicians.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Tokyo, Japan,Tohoku University School of Medicine, Sendai, Japan,*Anju Murayama,
| | - Momoko Hoshi
- Medical Governance Research Institute, Tokyo, Japan,Department of Public Health Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Tokyo, Japan
| | | | - Moe Kawashima
- Medical Governance Research Institute, Tokyo, Japan,School of Medicine, Fukushima Medical University, Fukushima, Japan
| | | | - Eiji Kusumi
- Department of Internal Medicine, Navitas Clinic Shinjuku, Tokyo, Japan
| | - Binaya Sapkota
- Nobel College Faculty of Health Sciences, Affiliated to Pokhara University, Kathmandu, Nepal
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
| | - Rajeev Shrestha
- Department of Pharmacy, District Hospital Lamjung, Besisahar, Nepal
| | | | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | | | - Tetsuya Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
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Murayama A, Kamamoto S, Shigeta H, Saito H, Yamashita E, Tanimoto T, Akihiko O. Undisclosed financial conflicts of interest with pharmaceutical companies among the authors of the Esophageal Cancer Practice Guidelines 2017 by the Japan Esophageal Society. Dis Esophagus 2022; 35:6671206. [PMID: 35980294 DOI: 10.1093/dote/doac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/19/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Minato-ku, Japan.,School of Medicine, Tohoku University, Sendai City, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato-ku, Japan.,School of Medicine, Hamamatsu University, Hamamatsu City, Japan
| | - Haruki Shigeta
- Medical Governance Research Institute, Minato-ku, Japan.,School of Medicine, Tohoku University, Sendai City, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Minato-ku, Japan.,Department of Internal Medicine, Soma Central Hospital, Soma City, Japan
| | | | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Japan.,Department of Internal Medicine, Navitas Clinic Tachikawa, Tachikawa City, Japan
| | - Ozaki Akihiko
- Medical Governance Research Institute, Minato-ku, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, 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: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Kamamoto S, Murayama A, Kusumi E, Yoshida M, Saito H, Sawano T, Yamashita E, Tanimoto T, Ozaki A. Evaluation of financial relationships between Japanese certified pediatric hematologist/oncologists and pharmaceutical companies: a cross-sectional analysis of personal payments from pharmaceutical companies between 2016 and 2019. Pediatr Blood Cancer 2022; 69:e29891. [PMID: 35949170 DOI: 10.1002/pbc.29891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022]
Abstract
This cross-sectional study evaluated the magnitude of personal payments made by pharmaceutical companies to pediatric hematologist-oncologists (PHOs) board-certified by the Japanese Society of Pediatric Hematology/Oncology (JSPHO), using publicly disclosed data. Among all 307 PHOs, 215 (70.0%) PHOs received $916 703 personal payments from 54 pharmaceutical companies between 2016 and 2019 in total. Median four-year payments per PHO was $1440 (interquartile range, $523-$4015). Payments per PHO significantly increased during the study period, by 23.8% (95% confidence interval: 15.3%-32.8%, P < 0.001) annually. Furthermore, leading PHOs, including university professors, society board members, and clinical practice guideline authors, received far larger personal payments from the companies.
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Affiliation(s)
- Sae Kamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Tohoku University School of Medicine, Sendai City, Miyagi, Japan
| | - Eiji Kusumi
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Navitas Clinic Shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Makoto Yoshida
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai City, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
| | - Erika Yamashita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Internal Medicine, Navitas Clinic, Tachikawa City, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
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50
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Murayama A, Kamamoto S, Higuchi K, Shigeta H, Ozaki A. Trend in industry payments to rheumatologists in the United States during the COVID-19 pandemic between 2013 and 2021. J Rheumatol 2022; 50:575-577. [PMID: 36182112 DOI: 10.3899/jrheum.220512] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The Open Payments Database (OPD), the legally binding database of payments made by pharmaceutical companies and device manufacturers to all physicians,1 was launched in 2013 in the United States, in order to improve transparency in financial relationship between healthcare professionals and industry. Meanwhile, large number of the general public and physicians were not aware of the OPD2,3 and there has been no reducing trend among rheumatologists so far.4.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Tohoku University School of Medicine, Sendai city, Miyagi, Japan; Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan; Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki city, Fukushima, Japan. Correspondence: Anju Murayama, Medical Governance Research Institute, Minato-ku, Tokyo, 1087505, Japan. Email address: . Conflicts of interest: Dr. Ozaki received personal fees from Medical Network Systems, a dispensing pharmacy, outside the scope of the submitted work. Regarding non-financial conflicts of interest among the study authors, the authors are engaged in ongoing research examining financial and non-financial conflicts of interest among healthcare professionals and pharmaceutical companies in Japan and the United States
| | - Sae Kamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Tohoku University School of Medicine, Sendai city, Miyagi, Japan; Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan; Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki city, Fukushima, Japan. Correspondence: Anju Murayama, Medical Governance Research Institute, Minato-ku, Tokyo, 1087505, Japan. Email address: . Conflicts of interest: Dr. Ozaki received personal fees from Medical Network Systems, a dispensing pharmacy, outside the scope of the submitted work. Regarding non-financial conflicts of interest among the study authors, the authors are engaged in ongoing research examining financial and non-financial conflicts of interest among healthcare professionals and pharmaceutical companies in Japan and the United States
| | - Kenichi Higuchi
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Tohoku University School of Medicine, Sendai city, Miyagi, Japan; Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan; Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki city, Fukushima, Japan. Correspondence: Anju Murayama, Medical Governance Research Institute, Minato-ku, Tokyo, 1087505, Japan. Email address: . Conflicts of interest: Dr. Ozaki received personal fees from Medical Network Systems, a dispensing pharmacy, outside the scope of the submitted work. Regarding non-financial conflicts of interest among the study authors, the authors are engaged in ongoing research examining financial and non-financial conflicts of interest among healthcare professionals and pharmaceutical companies in Japan and the United States
| | - Haruki Shigeta
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Tohoku University School of Medicine, Sendai city, Miyagi, Japan; Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan; Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki city, Fukushima, Japan. Correspondence: Anju Murayama, Medical Governance Research Institute, Minato-ku, Tokyo, 1087505, Japan. Email address: . Conflicts of interest: Dr. Ozaki received personal fees from Medical Network Systems, a dispensing pharmacy, outside the scope of the submitted work. Regarding non-financial conflicts of interest among the study authors, the authors are engaged in ongoing research examining financial and non-financial conflicts of interest among healthcare professionals and pharmaceutical companies in Japan and the United States
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Tohoku University School of Medicine, Sendai city, Miyagi, Japan; Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan; Department of Breast and Thyroid Surgery, Jyoban Hospital, Iwaki city, Fukushima, Japan. Correspondence: Anju Murayama, Medical Governance Research Institute, Minato-ku, Tokyo, 1087505, Japan. Email address: . Conflicts of interest: Dr. Ozaki received personal fees from Medical Network Systems, a dispensing pharmacy, outside the scope of the submitted work. Regarding non-financial conflicts of interest among the study authors, the authors are engaged in ongoing research examining financial and non-financial conflicts of interest among healthcare professionals and pharmaceutical companies in Japan and the United States
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