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.