Anju Murayama - Tohoku University School of Medicine, Sendai, Japan
Sae Kamamoto - Medical Governance Research Institute, Tokyo, Japan
Hiroaki Saito - Department of Internal Medicine, Soma Central Hospital, Soma, Japan
Erika Yamashita - Medical Governance Research Institute, Tokyo, Japan
Yosuke Suzuki - Medical Governance Research Institute, Tokyo, Japan
Tetsuya Tanimoto - Department of Internal Medicine, Navitas Clinic Kawasaki, Kawasaki, Japan
Piotr Ozieranski - Department of Social and Policy Sciences, University of Bath, Bath, UK
Akihiko Ozaki - Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan

Background  Financial relationships between healthcare institutions and pharmaceutical companies can lead to conflicts of interest (COIs), potentially compromising patients’ care. In Japan, scholarship donations, unique type of payments made to healthcare institutions and their subunits by pharmaceutical industries without restricting their use including non-educational or research purpose, may often have implicit promotional purposes. However, detailed information about these payments remains scarce.Methods  This study employed a cross-sectional design to analyse the extent and distribution of all scholarship donations made by all ۷۳ pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association (JPMA) to healthcare institutions in ۲۰۱۷. Data were obtained from publicly available sources from the companies, and the totalnumber of payments, their distributions across various institutions and specialties were analysed.Results  A total of ۲۷ ۰۰۷ payment contracts amounting to ۱۷۸ ۷۰۳ ۷۲۱ in scholarship donations were made to ۴۸۳۹ specific departments and laboratories at ۲۵۱ different institutions by ۶۷ pharmaceutical companies. National universities received ۵۰.۸% of total payments. All universities setting medical school in Japan received one or more payments. Domestic pharmaceutical companies contributed to ۱۳۷ ۷۹۷ ۳۰۲ (۷۷.۱%) in total. Clinical medicine departments received ۸۹.۶% (۱۶۰ ۱۱۳ ۱۴۷) with ۶.۲% (۱۱ ۰۱۱ ۹۴۶) and ۲.۰% (۳ ۶۰۰ ۴۵۶) allocated to basic medicine and social medicine specialties, respectively.Conclusion  This study provided a comprehensive overview of scholarship donations from pharmaceutical companies to healthcare institutions in Japan, revealing significant financial support primarily directed to national universities and clinical medicine departments. Japanese policy-makers should consider implementing regulations that promote transparency and mitigate potential COIs arising from scholarship donations, which may be useful in other countries with similar schemes.

Transparency, Japan, Pharmaceutical Payment, Non-research Payment, Institutional Conflicts of Interest, Health Policy