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Kamamoto S, Ozaki A, Murayama A. Assessment of Financial Relationships Between Otorhinolaryngologists and Pharmaceutical Companies in Japan Between 2016 and 2019. Cureus 2023; 15:e43633. [PMID: 37719565 PMCID: PMC10503947 DOI: 10.7759/cureus.43633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION There are prevalent financial relationships between physicians and the pharmaceutical industry in medical specialties, including otorhinolaryngology. Although these relationships might cause conflicts of interest, no studies have assessed the size and contents of the financial relationships between otorhinolaryngologists and pharmaceutical companies in Japan. This study aims to evaluate the magnitude, prevalence, and trend of the financial relationship between Japanese otolaryngologists and pharmaceutical companies. METHODS Using payment data publicly disclosed by 92 pharmaceutical companies, we examined the size, prevalence, and trend in personal payments made to the otorhinolaryngologist board certified by the Japanese Society of Otorhinolaryngology-Head and Neck Surgery (JSO-HNS) between 2016 and 2019 in Japan. Furthermore, differences in payments were evaluated by whether otolaryngologists were clinical practice guideline authors, society board members, and academic journal editors or not. Trends in payments were evaluated by generalized estimating equations. RESULTS Of 8,190 otorhinolaryngologists, 3,667 (44.8%) were paid a total of $13,873,562, in payments for lecturing, consulting, and writing by 72 pharmaceutical companies between 2016 and 2019. The median four-year combined payment per physician was $1,022 (interquartile range: $473-$2,526). Top 1%, 5%, and 10% of otorhinolaryngologists received 42.3% (95% confidence interval (95% CI): 37.2%-47.4%), 69.3% (95% CI: 65.9%-72.8%), and 80.6% (95% CI: 78.3%-82.9%) of overall payments, respectively. The median payments per physician were significantly higher among otorhinolaryngologists authoring clinical practice guidelines ($11,522), society board members ($22,261), and journal editors ($35,143) than those without. The payments and number of otorhinolaryngologists receiving payments remained stable between 2016 and 2019. CONCLUSION This study demonstrates that a minority but a large number of otorhinolaryngologists received personal payments from pharmaceutical companies for the reimbursement of lecturing, consulting, and writing in Japan. Large amounts of these personal payments were significantly concentrated on a small number of leading otorhinolaryngologists.
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Affiliation(s)
- Sae Kamamoto
- School of Medicine, Hamamatsu University, Hamamatsu, JPN
| | - Akihiko Ozaki
- Surgery, Teikyo University Graduate School of Public Health, Tokyo, JPN
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Jacobs JW, Martin AA, Larson AR, Gehrie EA, Silver JK, Booth GS. Analysis of Industry-Related Payments Among Physician Editors of Pathology Journals. Am J Clin Pathol 2023; 159:172-180. [PMID: 36594828 DOI: 10.1093/ajcp/aqac147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/24/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Gender inequities in editorial board representation and physician compensation are well documented, but few studies have focused on how editors of journals are compensated. METHODS In this cross-sectional study, we examined industry-related compensation (from 2014 to 2020) among physician editors of 35 pathology journals using publicly available data from the Centers for Medicare & Medicaid Services Open Payments Database. RESULTS Of the physician editors included, 135 (69.9%) were men and 58 (30.1%) were women. Similar percentages of men and women physicians who were eligible received payments (112/135 [83.0%] men and 51/58 [87.9%] women; P = .38, χ2 test). Of the total transfer of value ($211,192,532), 112 men received $192,727,555 (91.3%), and 51 women received $18,464,978 (8.7%). Mean total payment per person was $1,720,782 for men and $362,058 for women (P = .05). The payment range for men was $18-$47,568,400 and the range of payments for women was $31-$2,375,637. CONCLUSIONS The findings highlight significant gender inequities in industry-related payments to physician editors of pathology journals. The financial relationships of journal editors and industry deserve further study, particularly as they relate to advancing science and closing both workforce and patient care inequities.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Amarilis A Martin
- Central Michigan University, Mount Pleasant, MI, USA.,Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Detroit, MI, USA
| | - Allison R Larson
- Department of Dermatology, MedStar Health, Washington, DC, USA.,Department of Dermatology, Georgetown Medical Center, Washington, DC, USA
| | - Eric A Gehrie
- American Red Cross, National Headquarters, Washington, DC, USA
| | - Julie K Silver
- Department of Physical Medicine, Harvard Medical School, Boston, MA, USA.,Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Boston, MA, USA.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USAand
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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Murayama A, Shigeta H, Kamamoto S, Yamashita E, Saito H, Sawano T, Bhandari D, Shrestha S, Kusumi E, Tanimoto T, Ozaki A. Pharmaceutical Payments to Japanese Board‐Certified Head and Neck Surgeons Between 2016 and 2019. OTO Open 2023; 7:e31. [PMID: 36998569 PMCID: PMC10046701 DOI: 10.1002/oto2.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/15/2022] [Accepted: 12/25/2022] [Indexed: 02/19/2023] Open
Abstract
Objective To evaluate the magnitude, prevalence, and trend of the financial relationship between Japanese head and neck surgeons and pharmaceutical companies between 2016 and 2019. Study Design Cross-sectional analysis. Setting Japan. Methods This study evaluated personal payments concerning lecturing, consulting, and writing paid by 92 major pharmaceutical companies to all Japanese head and neck surgeons board-certified by the Japan Society for Head and Neck Surgery between 2016 and 2019. The payments were descriptively analyzed and payment trend were assessed using population-averaged generalized estimating equations. Further, the payments to board executive board members with specialist certification were also evaluated separately. Results Of all 443 board-certified head and neck surgeons in Japan, 365 (82.4%) received an average of $6443 (standard deviation: $12,875), while median payments were $2002 (interquartile ranges [IQR] $792-$4802). Executive board specialists with a voting right received much higher personal payments (median $26,013, IQR $12,747-$35,750) than the non-executive specialists (median $1926, IQR $765‒$4134, p < .001) and the executive board specialists without a voting right (median $4411, IQR $963-$5623, p = .015). The payments per specialist and prevalence of specialists with payments annually increased by 11.4% (95% CI: 5.8%-17.2%; p < .001) and 7.3% (95% CI: 3.8%-11.0%; p < .001), respectively. Conclusion There were increasingly widespread and growing financial relationships with pharmaceutical companies among head and neck surgeons in Japan, alongside of introduction of novel drugs. The leading head and neck surgeons received much higher personal payments from pharmaceutical companies, and no sufficient regulation was implemented by the society in Japan.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- School of Medicine Tohoku University Sendai city Miyagi Japan
| | - Haruki Shigeta
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- School of Medicine Tohoku University Sendai city Miyagi Japan
| | - Sae Kamamoto
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Faculty of Medicine Hamamatsu University School of Medicine Hamamatsu Shizuoka Japan
| | | | - Hiroaki Saito
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Internal Medicine Soma Central Hospital Soma City Fukushima Japan
| | - Toyoaki Sawano
- Department of Surgery Jyoban Hospital of Tokiwa Foundation Iwaki City Fukushima Japan
| | - Divya Bhandari
- Medical Governance Research Institute Minato‐ku Tokyo Japan
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia Jalan Lagoon Selatan Bandar Sunway Jalan Lagoon Selatan Malaysia
| | - Eiji Kusumi
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Internal Medicine Navitas Clinic Shinjuku Shinjuku‐ku Tokyo Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Internal Medicine Navitas Clinic Tachikawa Tachikawa City Tokyo Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute Minato‐ku Tokyo Japan
- Department of Breast and Thyroid Surgery Jyoban Hospital of Tokiwa Foundation Iwaki City Fukushima Japan
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Mitchell A, Sarpatwari A, Bach PB. Industry Payments to Physicians Are Kickbacks. How Should Stakeholders Respond? JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2022; 47:815-833. [PMID: 35867550 PMCID: PMC11107028 DOI: 10.1215/03616878-10041205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Payments from the pharmaceutical industry to US physicians are common. In determining which payments rise to the level of an illegal kickback under the Anti-Kickback Statute (AKS), the Department of Health and Human Services' Office of Inspector General (OIG) has stated in nonbinding guidance that influencing or "swaying" physician prescribing is key. OIG has highlighted as a compliance standard the Pharmaceutical Research and Manufacturers of America Code on Interactions with Health Professions, which stipulates that permissible payments are those that do not interfere with prescribing. However, recent evidence has shown that most payments influence physician prescribing, driving higher prescription drug costs by increasing use of brand-name and low-value drugs. This evidence implies that many payments that are currently commonplace could be subject to prosecution under AKS. Given that these payments increase costs to patients and the health care system, there is a public interest in curtailing them. This article proposes a range of actions available to stakeholders-including industry, providers, regulators, and payers-to mitigate the cost-increasing effect of industry payments to physicians.
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Mitchell AP, Trivedi NU, Gennarelli RL, Chimonas S, Tabatabai SM, Goldberg J, Diaz LA, Korenstein D. Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review. Ann Intern Med 2021; 174:353-361. [PMID: 33226858 PMCID: PMC8315858 DOI: 10.7326/m20-5665] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Financial payments from the drug industry to U.S. physicians are common. Payments may influence physicians' clinical decision making and drug prescribing. PURPOSE To evaluate whether receipt of payments from the drug industry is associated with physician prescribing practices. DATA SOURCES MEDLINE (Ovid), Embase, the Cochrane Library, Web of Science, and EconLit were searched without language restrictions. The search had no limiting start date and concluded on 16 September 2020. STUDY SELECTION Studies that estimated the association between receipt of industry payments (exposure) and prescribing (outcome). DATA EXTRACTION Pairs of reviewers extracted the primary analysis or analyses from each study and evaluated risk of bias (ROB). DATA SYNTHESIS Thirty-six studies comprising 101 analyses were included. Most studies (n = 30) identified a positive association between payments and prescribing in all analyses; the remainder (n = 6) had a mix of positive and null findings. No study had only null findings. Of 101 individual analyses, 89 identified a positive association. Payments were associated with increased prescribing of the paying company's drug, increased prescribing costs, and increased prescribing of branded drugs. Nine studies assessed and found evidence of a temporal association; 25 assessed and found evidence of a dose-response relationship. LIMITATION The design was observational, 21 of 36 studies had serious ROB, and publication bias was possible. CONCLUSION The association between industry payments and physician prescribing was consistent across all studies that have evaluated this association. Findings regarding a temporal association and dose-response suggest a causal relationship. PRIMARY FUNDING SOURCE National Cancer Institute.
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Affiliation(s)
- Aaron P. Mitchell
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Niti U. Trivedi
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Renee L. Gennarelli
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan Chimonas
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sara M. Tabatabai
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Johanna Goldberg
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Luis A. Diaz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Deborah Korenstein
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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Goshtasbi K, Lehrich BM, Abouzari M, Bazyani D, Abiri A, Papagiannopoulos P, Tajudeen BA, Kuan EC. Academic Rhinologists' Online Rating and Perception, Scholarly Productivity, and Industry Payments. Am J Rhinol Allergy 2020; 35:341-347. [PMID: 32915651 DOI: 10.1177/1945892420958366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The emergence of popular online rating websites, social media platforms, and public databases for industry payments and scholarly outputs provide a complete physician online presence which may guide choice and satisfaction. METHODS Websites of all U.S. otolaryngology academic institutions were queried for fellowship-trained rhinologists. Additional well-known and academically active rhinologists were identified by the senior author. Online ratings and comments were collected from Google, Healthgrades, Vitals, and RateMD websites, and weighted rating scores (RS) were calculated on a 1-5 scale. RESULTS A total of 210 rhinologists with 16 ± 9 years of practice were included, where 6901 online ratings (33 ± 47 per rhinologist) provided an average RS of 4.3 ± 0.6. RS was not different according to gender (p = 0.58), geographic quartile (p = 0.48), social media presence (p = 0.41), or attending top-ranked medical school (p = 0.86) or residency programs (p = 0.89). Years of practice negatively correlated with RS (R = -0.22, p<0.01), and academic ranking significantly influenced RS, with professors, associate professors, and assistant professors scoring 4.1 ± 0.6, 4.3 ± 0.4, and 4.4 ± 0.6, respectively (p = 0.03). Of the 3,304 narrative comments analyzed (3.1 ± 11.6 per rhinologist), 76% (positive) and 7% (negative) had elements of clinical knowledge/outcomes, 56% (positive) and 7% (negative) of communication/bedside manner, and 9% (positive) and 7% (negative) of office staff, cost, and wait-time. All negative comment categories had moderate negative correlation with RS, while positive comment categories regarding knowledge/competence and bedside manner weakly correlated with higher RS. Number of publications (48 ± 54) positively correlated with 2018 industry payments ($11,384 ± $19,025) among those receiving industry compensation >$300 (n = 113). Attending a top-ranked medical school was associated with higher industry payments (p<0.01) and H-index (p = 0.02). CONCLUSION Academic rhinologists' online RS was not associated with gender, geographic location, or attending a top-ranked training program, and their scholarly productivity was significantly correlated with total industry payments.
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Affiliation(s)
- Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Brandon M Lehrich
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Mehdi Abouzari
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Dariush Bazyani
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Arash Abiri
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | | | - Bobby A Tajudeen
- Department of Otolaryngology-Head and Neck Surgery, Rush University, Chicago, Illinois
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
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