Financial conflicts of interest among authors of clinical practice guidelines for diabetes mellitus in Japan

Abstract

Clinical practice guidelines (CPGs) serve as pivotal frameworks for standardizing evidence-based diagnostic and therapeutic approaches, particularly in the management of diabetes and beyond. 1,2 However, the integrity of these guidelines can be compromised by conflicts of interest (COIs). [3][4][5] Given that current increasing attention from pharmaceutical companies to diabetologists 6,7 and large prevalence of diabetes and obesity, proper management of financial COIs is essential for trustworthy diabetes CPGs. 1 Despite the critical nature of this issue, no research has investigated these financial relationships in the Japanese context.Using a publicly accessible database (https:// yenfordocs.jp/) containing personal payments for lecturing, consulting, and manuscript drafting from all pharmaceutical companies affiliated with the Japan Pharmaceutical Manufacturers Association, this study examined personal payments made to all authors for Japanese Clinical Practice Guideline for Diabetes 2019 (JCPGD) developed by the Japan Diabetes Society in 2019. 8 Descriptive analysis was performed on the payment data extracted from the database between 2016 and 2020.

Pharmaceutical company payments to Japanese breast cancer practice guideline authors

“…The high prevalence (77.2%) of financial ties to drug companies for non-research purposes among the authors in this study aligns with many previous studies in Japan, albeit with higher percentages. [3][4][5][6][7][8][9]13,41,42,[44][45][46][47][48] This could indicate a vulnerability to financial COI among the influential breast cancer experts in Japan. For example, the author previously reported that the proportions of authors accepting payments from drug companies were 66.0% in obstetrics and gynecology, 13 88% in nephrology, 5 88.2% in gastroenterology, 3,45 88.6% in urology, 46 90.6% in dermatology, 47 91.3%-100% in rheumatology, 4,41 87.0%-91.9% in infectious diseases, 6,44 94.4% in cardiology, 48 94.6% in hematology, 9 95.6% in a diabetes CPG, 42 96.3% in otolaryngology 7 and 100% in a CPG for hepatitis C treatment.…”

“…[3][4][5][6][7][8][9]13,41,42,[44][45][46][47][48] This could indicate a vulnerability to financial COI among the influential breast cancer experts in Japan. For example, the author previously reported that the proportions of authors accepting payments from drug companies were 66.0% in obstetrics and gynecology, 13 88% in nephrology, 5 88.2% in gastroenterology, 3,45 88.6% in urology, 46 90.6% in dermatology, 47 91.3%-100% in rheumatology, 4,41 87.0%-91.9% in infectious diseases, 6,44 94.4% in cardiology, 48 94.6% in hematology, 9 95.6% in a diabetes CPG, 42 96.3% in otolaryngology 7 and 100% in a CPG for hepatitis C treatment. 8 Meanwhile, previous studies in other high-income countries, such as the United States, the UK and Canada, reported lower fraction of COIs for CPG authors than TA B L E 4 New approval and indications of breast cancer drugs manufactured by the top five companies making the largest payments in Japan between 2010 and 2022.…”

“…38 Second, the study also investigated the proportion of authors who received payments exceeding specific thresholds, $10 000, $50 000, $100 000 and $250 000, as previously described. 3,41,42 Third, we reviewed the JBCS COI policy for the JBCS2022 authors and the JBCS2022 authors self-declared their financial COIs with drug companies between 2019 and 2021 following the JBCS COI policy. We evaluated their COI statements regarding lecturing, consulting and writing payments with the payment data that we collected from the database between 2019 and 2020.…”

Non-research payments to board-certified cardiologists from pharmaceutical industry in Japan from 2016 to 2019: a retrospective analysis

“…However, previous studies indicated significant undeclared and under-reported COIs between physicians and pharmaceutical companies in Japan. 2025 27 31 45 49 Our previous study elucidated that more than 94% of authors of clinical practice guidelines for cardiovascular diseases received personal payments from pharmaceutical companies in Japan. 45 Additionally, the policies used to manage COIs in Japan are less rigorous and transparent than those in other high-income countries.…”