Medical Device Industry Payments to Healthcare Professionals in Japan: A Descriptive Analysis of Scale, Distribution,...

Financial ties between healthcare professionals and the medical-device industry raise conflict-of-interest and transparency concerns; despite Japan's 2012 self-regulatory guidelines, device-related payments receive less scrutiny than pharmaceutical payments globally, including in Japan.

To provide the first detailed analysis of honoraria from medical device companies to Japanese physicians in 2019, offering a baseline before the COVID-19 pandemic.

We retrospectively examined 2019 payment data from the Yen for Docs database, compiled from disclosures by 118 companies affiliated with the Japan Medical Devices Network and other major firms. The analysis focused on honoraria-lecture, consulting, and writing fees-because these are the only categories disclosed with individual healthcare professionals names. Payments were standardized, cleaned, and aggregated at company and recipient levels. Descriptive analyses identified overall volume, company distribution, and top-earning specialties.

In 2019, 66 companies disclosed 60,161 honorarium payments totaling USD 46.0 million. Most funds (66.7%) were lecture fees, followed by consulting (28.8%) and writing (4.5%). Payments were highly concentrated: the top 10 companies accounted for 63.3% of the total, led by Medtronic, Terumo, and Johnson & Johnson. Among 24,434 recipients, 66.1% received less than USD 1,000, while only seven physicians received more than USD 100,000. Cardiologists (48.0%) and cardiovascular surgeons (24.0%) dominated the top 50 earners.

Honoraria from Japan's device industry were modest in scale compared with pharmaceutical companies but highly concentrated among a few firms and cardiovascular specialists. These findings highlight the need for more comprehensive and legally enforceable transparency frameworks to safeguard clinical integrity and public trust.