Pharmaceutical money to Japanese board-certified dermatologists: A four-year retrospective analysis of personal payments from pharmaceutical companies between 2016 and 2019

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 $1,737 ($613–$5,287) and 4.0 (2.0–10.0) over the four 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 four years.

Financial relationships between board‐certified neurologists and the pharmaceutical industry in Japan

“…1,2,8 Previous studies indicate that most Japanese physicians receive personal payments for speaking and consulting, excluding food and travel expenses. [10][11][12][13][14][15] Neurological disorders, particularly dementia, are receiving increasing attention from the pharmaceutical industry in Japan. The number of dementia patients is rising sharply, with 4.62 million cases reported in 2012, 16 and it is predicted that more than 20% of all people aged 65 years and older will have dementia by 2030.…”

“…The Japan Pharmaceutical Manufacturers Association (JPMA), representing over 70 leading pharmaceutical companies, mandates its members to disclose payments for lecturing, consulting and manuscript drafting to physicians, including recipients' names and affiliations, on their websites, as previously explained. 14,15 However, per JPMA guidelines, categories such as meals, travel, accommodations and other gifts are reported in aggregate, precluding individual-level analysis. 15 Therefore, our focus was on payments for lecturing, consulting and drafting services to neurologists.…”

“…However, it is important to note that substantial and widespread financial relationships between physicians and pharmaceutical companies are not confined to neurologists in Japan. Previous studies have demonstrated varying proportions of specialists receiving personal payments: 45.3% for dermatologists, 14 52.8% for gastroenterologists, 15 62.0% for pulmonologists, 10 64.7% for haematologists, 11 65.4% for infectious disease specialists, 25 70.7% for rheumatologists 13 and 70.7% for urologists. 12 Additionally, the payment amounts to neurologists are consistent with the ranges reported in these studies.…”

“…12 Additionally, the payment amounts to neurologists are consistent with the ranges reported in these studies. [10][11][12][13][14][15] Significant increasing trends in personal payments to neurologists were observed between 2016 and 2019. The marked decrease in 2020 is likely attributable to the COVID-19 pandemic and the consequent restrictions on interactions between physicians and pharmaceutical representatives.…”

“…Due to the non-normal distribution of payments, we used a log-linked GEE model with a poisson distribution for the number of neurologists receiving payments and a negative binomial GEE model for payments per neurologist. [12][13][14][15] The study period was divided into two intervals (2016-2019 and 2020) to assess the impact of the COVID-19 pandemic on payment patterns, as observed in previous studies in the United States. [18][19][20][21][22][23][24] For trend analysis, we adjusted for inflation, converting all payment values to their 2020 Japanese yen equivalents using the relative annual consumer price index.…”