Introduction
Although collaborations between industry and healthcare professionals can bring breakthroughs in medicine, several medical scandals and limited transparency in the financial relationships between healthcare professionals and pharmaceutical companies led to the concern for the undue influence of financial relationships on patient care. Since 2013, the Japan Pharmaceutical Manufacturers Association (JPMA), the largest pharmaceutical trade organization in Japan, has required all pharmaceutical companies belonging to the JPMA, whose share account for more than 80% of total sales for pharmaceutical products in Japan,[1] to disclose their payments made to healthcare professionals for lecturing, consulting, and writing, based on the JPMA voluntary transparency guidance.[2, 3] This voluntary payment disclosure by pharmaceutical companies enabled the evaluation of the detailed magnitude of the financial relationships between healthcare professionals and pharmaceutical companies in several specialties.[4-8]
As shown in previous studies in the United States, there are large and prevalent financial transfers from pharmaceutical industries to otorhinolaryngologists for various purposes,[9-13] as well as other specialty physicians.[14-21] The payments from pharmaceutical companies often disproportionately concentrate on small numbers of physicians in leading and authoritative positions who are required to be independent and unbiased from any industries,[4, 5, 22-26] namely key opinion leaders.[27, 28] This trend would exist among Japanese otorhinolaryngologists, considering previous studies showing that there were substantial and prevalent financial relationships between leading otorhinolaryngologists and pharmaceutical companies in other specialties in Japan.[4, 7, 29, 30] However, there was lack of assessment regarding the whole picture of the financial relationships between pharmaceutical companies and otorhinolaryngologists in Japan. Thus, this study aimed to evaluate the magnitude, prevalence, and trend in personal payments made to otorhinolaryngologists by pharmaceutical companies for the latest years in Japan.