{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:42:49Z","timestamp":1792428169082,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Financial relationships between pharmaceutical companies and the leaders of academic medical institutions may generate institutional conflicts of interest, yet payments to medical school deans and university hospital directors have not been examined nationally. We assessed the magnitude, concentration, and specialty pattern of pharmaceutical company payments to the leaders of all Japanese academic medical centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide cross-sectional study, we identified the deans and main-hospital directors of all 82 universities with a medical school in Japan for fiscal year 2023 (82 deans and 84 directors). Using payment disclosures from companies affiliated with the Japan Pharmaceutical Manufacturers Association, we aggregated personal payments (lecture, manuscript, and consulting fees) to each leader and described their amount, concentration, and distribution by specialty and payment category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 67 of 82 deans (81.7%) and 77 of 84 hospital directors (91.7%) received payments. Total payments were US$901,128 for deans (median US$4,894) and US$1,843,565 for directors (median US$14,031). Payments were highly concentrated: the top decile of recipients accounted for 43.9% (deans) and 36.4% (directors) of the total, and lecture fees comprised 85.2% and 88.5% of payments, respectively. The highest-paid specialties were orthopaedic surgery, urology, and pharmacology among deans, and respiratory medicine, urology, and haematology among directors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pharmaceutical payments to the leaders of Japanese academic medical centres were common, substantial, and concentrated among a small number of individuals and specialties, supporting the case for prohibiting personal promotional payments to institutional leaders while they hold office, with public disclosure as a minimum floor rather than an endpoint.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/intqhc\/mzag170","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:19:50Z","timestamp":1792408790000},"source":"Crossref","is-referenced-by-count":0,"title":["Pharmaceutical company payments to medical school deans and university hospital directors in Japan: a nationwide cross-sectional study"],"prefix":"10.1093","author":[{"given":"Keita","family":"Shimizu","sequence":"first","affiliation":[{"name":"Medical Governance Research Institute , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akemi","family":"Hara","sequence":"additional","affiliation":[{"name":"Medical Governance Research Institute , Tokyo,","place":["Japan"]},{"name":"University of North Carolina at Chapel Hill Department of Biostatistics, , Chapel Hill, NC,","place":["United States"]},{"name":"Jyoban Hospital of Tokiwa Foundation Clinical Research Center, , Iwaki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Ozieranski","sequence":"additional","affiliation":[{"name":"University of Bath Department of Social & Policy Sciences, , Bath,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan D","family":"Florez","sequence":"additional","affiliation":[{"name":"University of Antioquia Department of Pediatrics, , Medell\u00edn,","place":["Colombia"]},{"name":"Unity Health Toronto St Michael's Hospital, , Toronto,","place":["Canada"]},{"name":"Cl\u00ednica Las Am\u00e9ricas-AUNA Pediatric Intensive Care Unit, , Medell\u00edn,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangqin","family":"Xun","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences & Peking Union Medical College School of Population Medicine and Public Health, , Beijing,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne","family":"Estill","sequence":"additional","affiliation":[{"name":"Lanzhou University Evidence-Based Medicine Center, School of Basic Medical Sciences, , Lanzhou,","place":["China"]},{"name":"University of Geneva Institute of Global Health, , Geneva,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaolong","family":"Chen","sequence":"additional","affiliation":[{"name":"Lanzhou University Evidence-Based Medicine Center, School of Basic Medical Sciences, , Lanzhou,","place":["China"]},{"name":"Lanzhou University Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, , Lanzhou,","place":["China"]},{"name":"Lanzhou University WHO Collaborating Center for Guideline Implementation and Knowledge Translation, , Lanzhou,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudai","family":"Kaneda","sequence":"additional","affiliation":[{"name":"Jyoban Hospital of Tokiwa Foundation Clinical Training Center, , Iwaki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"Medical Governance Research Institute , Tokyo,","place":["Japan"]},{"name":"Navitas Clinic Kawasaki Department of Internal Medicine, , Kawasaki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Medical Governance Research Institute , Tokyo,","place":["Japan"]},{"name":"Jyoban Hospital of Tokiwa Foundation Breast and Thyroid Center, , Iwaki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,19]]},"container-title":["International Journal for Quality in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/intqhc\/advance-article-pdf\/doi\/10.1093\/intqhc\/mzag170\/72115405\/mzag170.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/intqhc\/advance-article-pdf\/doi\/10.1093\/intqhc\/mzag170\/72115405\/mzag170.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:16:41Z","timestamp":1792426601000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/intqhc\/advance-article\/doi\/10.1093\/intqhc\/mzag170\/8943599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/intqhc\/mzag170","relation":{},"ISSN":["1353-4505","1464-3677"],"issn-type":[{"value":"1353-4505","type":"print"},{"value":"1464-3677","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"article-number":"mzag170"}}