Introduction
Pharmaceutical companies frequently provide payments to physicians for both research and non-research activities[1,2]. Such financial interactions, while often instrumental in fostering healthcare innovation and enhancing patient care, may also engender potential conflicts of interest[3]. In Japan, pharmaceutical companies have been reported to make substantial non-research payments totaling $1.8 billion, with $1.1 billion allocated for the sponsorship of conferences and lectures geared toward drug promotion, and $236.0 million distributed for lecture and consulting services[4]. The majority of these lecture and consulting payments were directly made to individual physicians. Previous studies suggest that the incidence of non-research payments among Japanese physicians[5-12] surpasses that in other developed countries such as the United States, Australia, and France[1,13-19].
The discipline of allergy and clinical immunology has been marked by the introduction of numerous novel biologics for the treatment of allergic diseases, including asthma, atopic dermatitis, and allergic rhinitis. Concurrently, the last decade in Japan has witnessed the approval of new therapeutic agents for allergic rhinitis, such as antihistamines (e.g., rupatadine, desloratadine, and bilastine) and sublingual immunotherapy products.
The introduction of these novel drugs has expanded the therapeutic choices available to physicians and patients, yet the absence of comparative clinical trials assessing these drugs has resulted in increased promotional activities by pharmaceutical companies. Prior research indicates a yearly 7.2% increase in marketing payments to allergists in the United States, rising from $13.1 million in 2014 to $19.2 million in 2019[20]. Additionally, these payments were associated with the prescribing patterns of new biologics for moderate and severe asthma among allergists in the United States[21]. The scrutiny of the financial relationships between allergists and pharmaceutical companies is therefore of particular importance. However, data on these relationships in Japan remain sparse. This study aims to assess the financial interactions between allergists and pharmaceutical companies in Japan using publicly disclosed payment data.