Conflicts of Interest Among Cardiology Clinical Practice Guideline Authors in Japan

Abstract

Abstract Background: Clinical practice guidelines (CPGs) offer disease management recommendations based on scientific evidence. However, financial conflicts of interest (FCOIs) between CPG developers and the pharmaceutical industry could bias these recommendations, potentially affecting patient care. Proper management of these FCOIs is particularly crucial for maintaining the integrity of CPGs. Objectives: The study aimed to evaluate the extent of financial relationships between the pharmaceutical industry and authors of CPGs for cardiovascular diseases in Japan. Methods: The study analyzed personal payments from the pharmaceutical industry to authors of cardiovascular disease CPGs published by the Japanese Circulation Society (JCS) from January 2015 to December 2022. Payment data, including speaking, consultancy, and writing fees from 2016 to 2020, were extracted from a public available database containing personal payments disclosed by all major pharmaceutical companies. Results: A total of 929 unique authors from 37 eligible JCS CPGs were identified. Notably, 94.4% of these authors received personal payments from pharmaceutical companies, totaling over US$70.8 million. The mean and median payment per author was US$76,314 (standard deviation: US$138,663) and US$20,792 (interquartile range: US$4,262 – US$76,998) over the five-year period. Chairpersons of CPGs received significantly higher payments than other authors. More than 80% of authors in each CPG received personal payments. Conclusions: The study revealed extensive financial ties between pharmaceutical companies and cardiology CPG authors in Japan, with 94% of authors receiving significant payments. This finding deviates from international FCOI management policies, suggesting the need for more stringent COI management strategies by the JCS to ensure the development of trustworthy and evidence-based CPGs.