key: cord-0966203-cvcvv1dr
authors: Murayama, Anju; Ozaki, Akihiko; Saito, Hiroaki; Sawano, Toyoaki; Sah, Ranjit; Tanimoto, Tetsuya
title: Coronavirus disease 2019 experts appearing on Japanese television: their characteristics and financial conflicts of interest with pharmaceutical companies
date: 2020-12-11
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2020.12.002
sha: 8fd2b5f46360f7c5d32b124188b7299f24f5c058
doc_id: 966203
cord_uid: cvcvv1dr

Financial conflicts of interest between pharmaceutical companies and medical experts appearing on television remain opaque. We revealed that seven (63.6%) of the 11 medical experts on non-satellite Japanese television programs covering COVID-19 received a combined $317,324 from 19 pharmaceutical companies in 2017. Further, only one of the experts published a single academic paper related to COVID-19. Also, over half the medical experts appearing on television were practicing clinicians and predominantly male.

To the Editor, Global efforts to regulate financial conflicts of interest (FCOI) between pharmaceutical companies and health-care sectors have gained popularity over the past decade. This arose primarily over concerns of the inappropriate influence FCOI may have on delivery of patient-centred care [1] . However, regulatory practices involving FCOI between pharmaceutical companies and the media industry attract little attention. Coronavirus disease 2019 (COVID-19) is currently the centre of attention among global and domestic mass media, with numerous daily reports. Among them, television in particular is influential [2] , and various academic experts appear to offer advice, suggestions and personal comments concerning COVID-19. We aimed to elucidate the characteristics of those medical experts who were appearing frequently on television discussing COVID-19, and to investigate their FCOI with pharmaceutical companies in Japan.

Nihon Monitor Co., Ltd, identified the medical experts featured on all televised programmes related to COVID-19 by six nationwide non-satellite television channels based in Tokyo. All broadcasts occurred between 1 January and 30 June 2020. Using 2017 FCOI data disclosed by pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association (JPMA), we identified payments for lectures, manuscript preparation and consultations, as described previously [3] . We also collected demographic data on medical experts, including gender, specialty, and whether they provided medication using web-accessible information. Finally, we accessed PubMed for academic papers related to COVID-19 written by them as of 14 August 2020.

We performed a descriptive analysis of the number of television programmes, payments received and academic articles associated with each expert. Based on the JPMA report [4] , we calculated the total payment amount made by each pharmaceutical company and compared the means of these payments between those companies pursuing the manufacture of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test-kits, therapeutics or vaccines, against those that were not (see Supplementary material, Table S1 ). We converted Japanese yen to US dollars using the 2017 average monthly exchange rate of 112.1 yen per dollar. Table 1 shows the rankings and characteristics of the 11 most frequently appearing medical experts on Japanese television. The participants were overwhelmingly male (90.9%), and 54.5% of these experts provided medical care in hospitals or clinics. Only one expert had published a single academic paper on COVID-19. Financially, seven (63.6%) received a combined $317 324 in payments during 2017 made by 19 (26.0%) of the 73 pharmaceutical companies belonging to the JPMA. Companies with SARS-CoV-2 products made average (standard deviation) payments to the seven experts of $19 850 ($22 871). For those companies lacking SARS-CoV-2 products, the average (standard deviation) payment was $12 371 ($9706). Notably, three experts received more than $10 Table 1 Demographic and financial characteristics of the ten most featured COVID-19 medical experts on television between January and June of 2020 000 each from Fujifilm Toyama Chemical Co., MSD K.K. and Pfizer, Inc., all of which are developing potential COVID-19 therapeutics and vaccines. Seven of the 11 most frequently cast medical experts on Japanese television during the first 6 months of the COVID-19 pandemic had financial relationships with pharmaceutical companies dating back to 2017. Medical experts on television play a vital role in Japanese society for effectively conveying information to the general public about COVID-19. However, the FCOI between these experts and pharmaceutical companies, especially those with COVID-19 products, warrants caution in interpreting their comments. Although lecture or public-speaking fees paid by pharmaceutical companies are not intrinsically corrupt, such financial ties may lead to socially and politically problematic situations, including biased statements. Importantly, concern over FCOI stems from a lack of transparency as media-related entanglements are rarely disclosed on television programmes or related websites.

Interestingly, academic achievement on COVID-19 contributed little to the casting of experts. Although scholarly works do not necessarily guarantee an excellent ability to communicate with the general public, the absence of distinguished experts probably compromised the general public's understanding and uptake of newly published, peer-reviewed research findings on COVID-19.

Notably, just over half of the medical experts appearing on television were practicing clinicians and predominantly male. Consequently, there were no practicing female clinicians, reflecting how the male dominance in Japanese medical society also extends to television programming. This finding suggests that the voices of females working for COVID-19-related care may be underrepresented in media outlets, though medical care is delivered mainly by a female workforce. Although the number of female researchers has been consistently increasing each year in Japan, in 2018, the proportion of female physicians ranked the lowest, at 21.8%, among the 34 countries belonging to the Organization for Economic Cooperation and Development [5] . Despite expanding roles of the internet, television remains the most reliable and important means of acquiring information for the public worldwide [2] . Given the impact of television on the public [2] , fair and equal casting of medical experts could be significant in establishing effective and unbiased health communication in television programmes, not only in Japan but also in other countries.

A limitation of this study is that we could not evaluate experts' actual comments in the television programmes or consider financial relationships between pharmaceutical and television companies. Nor could we include the payments from 2018 onwards because the 2017 payment information was the latest available for analysis. In addition, we do not know whether the experts disclosed any potential conflicts to the media organizations that booked them to appear.

Payments from pharmaceutical companies to authors involved in the valsartan scandal in Japan

Trends and predictors of COVID-19 information sources and their relationship with knowledge and beliefs related to the pandemic: nationwide cross-sectional study

Pharmaceutical company payments to dermatology clinical practice guideline authors in Japan

Research and development efforts for therapeutic drugs and vaccines of each pharmaceutical company belonging to the JPMA

Organization for Economic Co-operation and Development, Health Care Resources. Physicians by age and gender

The authors wish to thank Erika Yamashita for collecting data and Professor Andy Crump and Dr Derek Hagman for constructive advice for this study.

Supplementary data to this article can be found online at https://doi.org/10.1016/j.cmi.2020.12.002.

Conceptualization and methodology were by AM, AO, HS, TS, RS and TT. Software, data curation, formal analysis and investigation were by AM. Visualization was by AM, AO and TT. The original draft was written by AM, AO and TT, who also reviewed and edited the article. The study was supervised by AO and TT, who also performed the project administration.

Outside the scope of the submitted work, personal fees were received by Dr Saito from Taiho Pharmaceutical Co., Ltd, from Medical Network Systems by Drs Ozaki and Tanimoto, and from Bionics Co., Ltd, by Dr Tanimoto. The remaining authors declare no conflicts of interest. This study was funded in part by the Medical Governance Research Institute, a nonprofit enterprise that receives donations from pharmaceutical companies, including Ain Pharmaciez, Inc, other organizations, and private individuals. This study also received support from the Waseda Chronicle, an independent nonprofit news organization dedicated to investigative journalism. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.