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\begin{document}

\title{Awareness and perceptions among members of a Japanese cancer patient
advocacy group concerning the financial relationships between the
pharmaceutical industry and physicians: a mixed-methods analysis of
survey data}



\author[1]{Anju Murayama}%
\author[1]{Yuki Senoo}%
\author[1]{Kayo Harada}%
\author[2]{Yasuhiro Kotera}%
\author[1]{Yosuke Suzuki}%
\author[3]{Hiroaki Saito}%
\author[4]{Toyoaki Sawano}%
\author[1]{Tetsuya  Tanimoto}%
\author[4]{Akihiko Ozaki}%
\affil[1]{Medical Governance Research Institute}%
\affil[2]{University of Derby}%
\affil[3]{Sendai Kosei Hospital}%
\affil[4]{Joban Hospital}%


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  \date{June 18, 2024}


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\begin{abstract}
Rationale, aims and objectives Financial conflicts of interest (FCOI)
between pharmaceutical companies (Pharma) and healthcare domains may
unduly influence physician-led clinical practice and patient-centered
care. However, the extent of awareness and perceptions of FCOI among
Japanese cancer patients remains unclear. This study aimed to assess
these factors and their impacts on physician trustworthiness among
Japanese cancer patients. Methods A cross-sectional study using
self-administered surveys was conducted on a Japanese cancer patient
advocacy group with 800 registered members from January to February
2019. Main outcome measures included awareness and perceptions of
physician-Pharma interactions, their impact on physician
trustworthiness, and attitudes towards FCOI among professions. We also
performed thematic analyses on additional comments responders provided
in the surveys. Results Among the 524 invited members, 96 (18.3\%)
completed the questionnaire. Of these, 69 (77.5\%) were cancer patients.
The proportion of participants aware of such interactions ranged from
2.1\% to 65.3\%, depending on the interaction type. Participants were
generally neutral on how the interactions would affect physician
trustworthiness. A large proportion of participants agreed that these
interactions were unethical, could influence physicians' prescribing
behavior leading to unnecessary prescriptions, and negatively affect
physician trustworthiness. Qualitative responses (n=56) indicated that
patients expected physicians to use sound ethical judgment and avoid
accepting incentives. Participants were also concerned about their
treatment and the undue influence of FCOI on physicians. Conclusion Most
participants were aware of at least one FCOI between Pharma and
physicians and perceived them negatively. Further efforts to regulate
FCOI appear necessary to protect patient-centered care.%
\end{abstract}%



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