Nature and Trends of Pharmaceutical Payments to Board Certificated Respiratory Specialists in Japan between 2016 and 2019

BackgroundThere are financial relationships between healthcare professionals and pharmaceutical companies, and these relationships 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. MethodsBased 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 prevalence of specialists with payments. ResultsAmong 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 cases from 72 (78.3%) pharmaceutical companies between 2016 and 2019. The mean{+/-}SD and median (interquartile range) four-year combined payment values per specialist were $12,134{+/-}$34,045 and $2,210 ($715{square}$8,178) respectively. At maximum, one specialist received $495,332 personal payments over the four years. Both payments per specialist and prevalence of specialists with payments significantly increased during the four-year period, with 7.8% (95% CI: 5.5{square}9.8; p<0.001) in payments and 1.5% (95% CI: 0.61% {square}2.4%; p = 0.001) in prevalence of specialists with payments, respectively. ConclusionMajority of respiratory specialists had increasingly received substantial 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.