Cross-sectional analysis of pharmaceutical industry payments to board-certified breast cancer specialists in Japan

Abstract

Financial interactions between pharmaceutical companies and physicians introduce conflicts of interest among physicians, and can unduly influence physicians' clinical decision-making, such as increased use of non-recommended cancer treatments and higher healthcare expenditures. Breast cancer is the most common cancer for which there is a growing number of novel treatments. Nevertheless, the financial relationships between pharmaceutical companies and physicians treating patients with breast cancer remain unknown. Using payment data disclosed by major pharmaceutical companies in Japan between 2016 and 2020, this study examined size and trends in non-research payments from the pharmaceutical companies to breast cancer specialists who were board-certified by the Japanese Breast Cancer Society. A total of $17.2 million were made to 1349 or 77.8% of all board-certified breast cancer specialists over the five years. Of all specialists, 41.9% to 55.5% received the payments each year. The median payments per specialist were $1,149–$1,371 annually. Only 5op 1% and 10% of all specialists received 24.7% and 70.3% of all payments to the specialists. The payments per specialist significantly increased by 9.9% (95% confidence interval: 6.713.1, p < 0.001) from 2016 to 2019, but decreased by 29.6% (95% CI: −34.4 to −24.5, p < 0.001) in 2020 when the COVID-19 pandemic occurred. Given that even a small payment to physicians is associated with their clinical practice, it is imperative that these breast cancer specialists are more aware of the potential influence of payments on their decision-making.