Financial conflicts of interest among authors of clinical practice guideline for headache disorders and board-certified neurologists in Japan

Abstract Aims: To evaluate fraction and size of financial conflicts of interest (COIs) between authors of Clinical Practice Guideline for Headache Disorders (CPGHD) and pharmaceutical companies in Japan.Methods: This retrospective analysis of personal payments data disclosed by pharmaceutical companies examined extents of financial relationships between all CPGHD authors and pharmaceutical companies in Japan. To compare the size and prevalence of payments to CPGHD authors with general neurologists, all neurologists who were board-certified by the Japanese Society of Neurology were also included in this study. Personal payments from pharmaceutical companies to the CPGHD authors and neurologists between 2016 and 2020 were extracted from public database and each pharmaceutical company.Results: Among 57 CPGHD authors, 56 (98.3%) received personal payments totalling $2.7 million from pharmaceutical companies between 2016 and 2020. Median five-year payments were $89,955 for CPGHD authors, while $521 for board-certified neurologists. The CPGHD chairperson and vice chairperson received substantial payments during the guideline development period. Nevertheless, because of less rigorous and transparent COI policy compared to international standard policies, only 10 authors disclosed their financial relationships with the pharmaceutical companies in the guideline.Conclusion: More than 98% of CPGHD authors received much higher personal payments from pharmaceutical companies than those to board-certified neurologists during the guideline development period in Japan. These findings would highlight the urgent need for policy interventions and increased transparency in financial relationships between guideline authors and pharmaceutical industry in Japan.