Quantifying pharmaceutical and medical device industry-physician financial ties: An analysis of honorarium payments to Japanese medical association leadership between 2019 and 2021

Objective: To assess the extent and distribution of pharmaceutical and medical device industry honorarium payments to medical association leadership, enhancing our understanding of industry-physician financial ties in Japan. 

Methods: We conducted a retrospective analysis of publicly disclosed payment data from pharmaceutical companies affiliated with the Japan Pharmaceutical Manufacturers Association and medical device companies affiliated with the Medical Devices Network. Data covered honorarium payments for speaking, writing, and consulting to board members of 18 major professional medical associations from 2019 to 2021. 

Results: Of the 399 executive board members, 373 (93.5 %) received payments totaling $15.99 million. The median payment per member over the three years was $22,529, (interquartile range [IQR], $7230.8–$57,223.9). Payments were concentrated, with four professional medical associations—representing Internal Medicine ($2.97 million), Ophthalmology ($1.78 million), Dermatology ($1.78 million), and Urology ($1.87 million)—accounting for 52.5 % of the total. Surgical specialties received a higher proportion of payments from medical device companies, while non-surgical specialties – pharmaceutical companies. Payments declined in 2020, coinciding with the COVID-19 pandemic, recovering by 2021. None of the 18 associations' leadership publicly disclosed their board members' financial ties. 

Conclusions: We found extensive and concentrated ties between industry and medical association leadership in Japan, with the pharmaceutical and medical device sectors each displaying distinctive payment patterns. The substantial scale of payments and limited transparency displayed by the association highlight the urgent need for legally mandated disclosure, including specialty-specific solutions.