Discussing the Influence of Money in Medicine: Yen for Docs Database Public Symposium

Tetsuya Tanimoto, M.D.

Physician, Medical Governance Research Institute

The Medical Governance Research Institute has been at the forefront of transparency in healthcare, showcasing the ties between pharmaceutical companies and medical professionals. Since fiscal year 2016, we have maintained and updated the "YEN FOR DOCS" database, a comprehensive record of payments made to healthcare professionals and institutions. The latest update, including the 2020 data, was released on September 11th, and on September 17th, we successfully hosted an online public symposium to deliberate on these revelations. The event witnessed significant engagement, with approximately 50 attendees.

Our institute's director, Akihiko Ozaki, who is pivotal to the Pharmaceutical Money Project, facilitated the symposium, while our chairman, Masahiro Kami, delivered the opening address. Kami emphasized that the crux of addressing pharmaceutical money is to nurture public trust. He underscored that the frequent discussions of this topic in American and British medical journals reflect the value these associations place on such trust. He also highlighted the sluggish progress on this issue within the Japanese government, despite the urgency underscored by criminal cases like that of Mie University, suggesting a strong prosecutorial will to address potential impacts on local healthcare.

Shu Watanabe, editor-in-chief at Tansa—a non-profit organization focusing on investigative journalism—recounted the initial resistance to disclosing financial interactions with pharmaceutical entities. However, persistent inquiries from major media outlets, including NHK, reinforced the belief that medical professionals, who hold lives in their hands, are public figures akin to politicians. This scrutiny led to a partnership with our institute and paved the way to where we are today. Watanabe concluded with a poignant reminder that doctors' primary allegiance should be to their patients, not the pharmaceutical industry.

Hiroaki Saito provided a comparative analysis titled "Differences in Financial Disclosure Systems in Japan and the UK," highlighting the progress mainly in the West and the need for international collaboration. Contrasting Japan's voluntary disclosure with the UK's stringent reporting requirements and penalties for non-compliance, Saito underscored the systemic differences and the need for a more rigorous approach.

Yosuke Suzuki discussed the extensive reach of the pharmaceutical money database, revealing that from January 2019 to May 2021, the platform attracted 350,000 unique visitors, 600,000 sessions, and 5.6 million page views, with daily users averaging 600. The data indicates heightened interest correlating with database updates or pharmaceutical-related incidents. A concurrent survey found that about 30% of users were medical professionals, while roughly 10% were affiliated with pharmaceutical companies.

Erika Yamashita presented an analysis of the latest trends in pharmaceutical payments, noting a significant decrease in the total amount of honoraria in fiscal year 2020, a likely consequence of the COVID-19 pandemic. Yet, the data anticipates a rebound to approximately 160 billion yen in fiscal year 2021, driven by the rise of web-based lectures. She also explored the phenomenon of scholarship donations, a unique aspect of Japan's pharmaceutical money. Though there has been a recent decline, with some companies discontinuing the practice, the estimated 20 billion yen in 2017 still holds substantial influence, comparable to the Grants-in-Aid for Scientific Research.

We are in the process of organizing future symposiums to continue these critical conversations and invite our readers to take part in these discussions.

This article was originally published in Japanese in Iyakukeizai (Pharmaceuticals and Economics) on October 1, 2023.