Medical Device Industry Payments to Healthcare Professionals and Organizations in Japan: An Evaluation of Scale, Distribution, and Transparency Practices, 2019-2022
8 affiliations
- 1Medical Governance Research Institute, Tokyo, Japan.
- 2Department of Research and Academics, Kathmandu Cancer Center, Bhaktapur, Nepal.
- 3Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan.
- 4Department of General Practice, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
- 5Department of Social and Policy Sciences, University of Bath, Bath, UK.
- 6NIHR Newcastle Patient Safety Research Collaboration, Newcastle University, Newcastle upon Tyne, UK.
- 7Navitas Clinic Kawasaki, Kanagawa, Japan.
- 8Breast and Thyroid Center, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan.
Abstract
Background:: Financial relationships between the medical device industry and healthcare providers have raised concerns about conflicts of interest (COIs). However, these relationships remain poorly characterized in Japan, despite the country’s large medical device market, which was valued at ¥4.41 trillion ($33.3 billion) as of 2021. This study examined the scale, composition, and temporal patterns of payments from the medical device industry and evaluated current transparency practices.
Methods:: We analyzed publicly disclosed payment data from 117 medical device companies predominantly affiliated with the Japan Federation of Medical Devices Associations (JFMDA) from 2019 to 2022. Payment categories included research and development, academic research support, lecture and consulting fees, information-provision–related expenses, and other payments to healthcare professionals (HCPs) and healthcare organizations (HCOs). We assessed payment magnitude, category composition, company-level concentration, year-to-year changes, and disclosure transparency using an adapted proforma previously applied to European pharmaceutical payment data.
Results:: Total payments amounted to $942.3 million over four years. Academic research support expenses constituted the largest share (33.0%, $310.7 million), followed by information provision–related expenses (25.2%, $237.5 million) and research and development expenses (21.7%, $204.8 million). Payments were highly concentrated, with the top 10 companies accounting for approximately 58% of total amounts. Using 2019 as the pre-pandemic baseline, total payments declined by 30.2% in 2020 and remained below pre-pandemic levels in 2021 (−24.0%), before partially recovering in 2022 (−11.6%). Category-specific trends diverged during the pandemic, with consulting, lecturing, and manuscript-related fees exceeding pre-pandemic levels by 2022, while information provision–related expenses remained substantially reduced. Transparency was limited: 78.6% of companies disclosed payment data with limited standardization, searchability, or data download functionality.
Conclusion:: This multi-year analysis revealed substantial financial relationships between the medical device industry and healthcare stakeholders in Japan, alongside persistent shortcomings in transparency of disclosures. Introducing legally mandated disclosure would improve oversight and align Japan’s system with international best practices.
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BibTeX
@article{hara2026medical,
title = {{Medical Device Industry Payments to Healthcare Professionals and Organizations in Japan: An Evaluation of Scale, Distribution, and Transparency Practices, 2019-2022}},
author = {Akemi Hara and Sunil Shrestha and Hiroaki Saito and James Larkin and Frank Moriarty and Piotr Ozieranski and Rajeev Shrestha and Tetsuya Tanimoto and Akihiko Ozaki},
journal = {International Journal of Health Policy and Management},
year = {2026},
month = jun,
doi = {10.34172/ijhpm.9079},
url = {https://doi.org/10.34172/ijhpm.9079},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Medical Device Industry Payments to Healthcare Professionals and Organizations in Japan: An Evaluation of Scale, Distribution, and Transparency Practices, 2019-2022
AU - Akemi Hara
AU - Sunil Shrestha
AU - Hiroaki Saito
AU - James Larkin
AU - Frank Moriarty
AU - Piotr Ozieranski
AU - Rajeev Shrestha
AU - Tetsuya Tanimoto
AU - Akihiko Ozaki
PY - 2026
DA - 2026/06/01
JO - International Journal of Health Policy and Management
DO - 10.34172/ijhpm.9079
UR - https://doi.org/10.34172/ijhpm.9079
AB - Background:: Financial relationships between the medical device industry and healthcare providers have raised concerns about conflicts of interest (COIs). However, these relationships remain poorly characterized in Japan, despite the country’s large medical device market, which was valued at ¥4.41 trillion ($33.3 billion) as of 2021. This study examined the scale, composition, and temporal patterns of payments from the medical device industry and evaluated current transparency practices. Methods:: We analyzed publicly disclosed payment data from 117 medical device companies predominantly affiliated with the Japan Federation of Medical Devices Associations (JFMDA) from 2019 to 2022. Payment categories included research and development, academic research support, lecture and consulting fees, information-provision–related expenses, and other payments to healthcare professionals (HCPs) and healthcare organizations (HCOs). We assessed payment magnitude, category composition, company-level concentration, year-to-year changes, and disclosure transparency using an adapted proforma previously applied to European pharmaceutical payment data. Results:: Total payments amounted to $942.3 million over four years. Academic research support expenses constituted the largest share (33.0%, $310.7 million), followed by information provision–related expenses (25.2%, $237.5 million) and research and development expenses (21.7%, $204.8 million). Payments were highly concentrated, with the top 10 companies accounting for approximately 58% of total amounts. Using 2019 as the pre-pandemic baseline, total payments declined by 30.2% in 2020 and remained below pre-pandemic levels in 2021 (−24.0%), before partially recovering in 2022 (−11.6%). Category-specific trends diverged during the pandemic, with consulting, lecturing, and manuscript-related fees exceeding pre-pandemic levels by 2022, while information provision–related expenses remained substantially reduced. Transparency was limited: 78.6% of companies disclosed payment data with limited standardization, searchability, or data download functionality. Conclusion:: This multi-year analysis revealed substantial financial relationships between the medical device industry and healthcare stakeholders in Japan, alongside persistent shortcomings in transparency of disclosures. Introducing legally mandated disclosure would improve oversight and align Japan’s system with international best practices.
SN - 2322-5939
ER -