Exposing corruption and promoting transparency: deepening the collaboration between the Centre of Analysis of Social Policy and Society (CASPS) and the Medical Governance Research Institute, Japan

Dr Akihiko Ozaki

Medical Governance Research Institute, Tokyo, Japan

Aichi Medical University, Aichi, Japan

Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan

Hello, my name is Akihiko Ozaki, MD, PhD. In my day job I work as an oncologist specialising in breast surgery in Fukushima, Japan. In addition, in my spare time I focus on analysing, evaluating, and finding ways of improving how transparency and conflicts of interest are managed in healthcare. I carry out this work together with colleagues from the Medical Governance Research Institute (MEGRI) and Aichi Medical University, with some of whom I will be visiting the Centre for the Analysis of Social Policy in March 2023.

Ahead of our visit, I would like to introduce you to the history and work of MEGRI. The Institute was founded in 2016 by the hematologist Dr Masahiro Kami, as a non-profit organization, with the goal of addressing various healthcare issues from a grassroots perspective.

One of the Institute's long-standing efforts is to address financial and other fraud in the Japanese medical field. In 2018, we launched the Pharmaceutical Money “Yen For Docs” Project in collaboration with investigative journalist group Tansa (formerly the Waseda Chronicle) (https://en.tansajp.org/). Tansa originally aimed to gather information on honoraria and donations paid to medical professionals by pharmaceutical companies, however, due to the sensitive nature of the issue, no mass media outlets were willing to participate. Thus, Makoto Watanabe, an editor-in-chief of Tansa and former employee of Asahi Shimbun Newspaper Company in Japan, approached his long-term friend Dr. Kami, and the project began. Our collaboration with Tansa was highlighted in an article in The British Medical Journal in 2022 (https://www.bmj.com/content/377/bmj.o1209/article-info). I am a founding member of this project because I became interested in this issue after conducting a campaign investigating questionable financial relationships in the CREATE-X Trial, a clinical trial conducted in partnership with Chugai Pharmaceutical Company, a subsidiary of F. Hoffmann-La Roche, Ltd. (https://en.tansajp.org/investigativejournal_category/cancerstudy/).

We spent a significant amount of time compiling the gathered data into a single integrated database named “Yen For Docs Database”, which is now publicly available. To date, we have released data from 2016 to 2019 and over 200,000 people use the database annually. Of note, in 2019, using this database, the Ministry of Education, Culture, Sports, Science and Technology in Japan discovered that 29 Japanese physicians received more than 15 million Japanese yen in compensation from pharmaceutical companies; specifically, ten were diabetes specialists and eight were cardiologists. We are proud that this database was created by a non-profit organization, not a government or trade organization, and it was a ground-breaking experiment.

So far, we have used the database to publish over 50 papers analyzing the financial relationship between pharmaceutical companies and the medical community and some of them were published in prestigious medical journals such as JAMA Internal Medicine, JAMA Network Open, Clinical Microbiology, Infection, and Clinical Pharmacology and Therapeutics. In these works, we disclosed that a presence of significant and questionable financial relationships between pharmaceutical companies and influential medical doctors including professors, clinical practice guideline authors, and executive board members of professional medical associations. We also chased scandals such as Diovan Scandal and Mie University Scandal.

I met CASPS member Dr. Piotr Ozieranski in 2019 as part of an exploratory visit to the University of Bath. We have steadily strengthened our collaboration by working on several joint publications, including an international comparison of the governance of transparency in the UK and Japan, soon to be published in the prestigious journal Globalization and Health.

We are very excited to support the research visit of our collaborator, Mr Anju Murayama, to CASPS in February and March 2023. And we will also be attending an international symposium on transparency in healthcare which will be hosted by CASP on the 7^th March 2023.

Please do not hesitate to get in touch with me (email ozakiakihiko@gmail.com ) should you be interested in meeting us and discussing research and collaboration ideas during our visit.