"Cash by providing surgical videos" Is it the purpose of securing lens sales on the manufacturer side?

The problem was that the medical device maker "Star Japan" was paid cash by receiving surgical videos using its own lenses from multiple ophthalmologists nationwide for academic purposes. Interviews with multiple parties have newly revealed that it seems that they were providing cash for the purpose of securing sales of lenses.

It is suspected that such an act violates the rules of self-regulation of industry groups based on the prize labeling law, and the Ministry of Health, Labor and Welfare and the Fair Trade Commission created by the industry are investigating the details.

Star Japan commented, "We are reporting to industry groups and investigating the facts. We take the situation very seriously."

"Star Japan", a Japanese subsidiary of an American medical equipment manufacturer and headquartered in Urayasu City, Chiba Prefecture, creates videos of cataract surgery using the lenses of this company with multiple ophthalmologists working at general hospitals nationwide. I signed a contract to do so, received the video, and paid cash.

According to interviews with related parties, the number of working doctors who had contracts reached at least 14 in the three years up to last year, and the total amount of cash provided exceeded 9 million yen.

Regarding the purpose of providing the video, the contract document states that it "contributes to academic materials", but there is a suspicion that the manufacturer actually provided cash to doctors mainly for the purpose of securing sales of lenses. Interviews with multiple company officials have revealed that there is something new.

In the internal materials obtained by NHK, such a mechanism is named "Video Campaign" and is described as "one of the measures to achieve the annual plan".

Also, the amount to be paid to the doctor was decided according to the number of lenses purchased.

In response to NHK's interview, one of the former employees said that it was a de facto rebate, and said, "The aim was to give a reward to the doctor so that he could preferentially use his own lens and secure a share." I testify.

Providing cash to doctors for sales promotion by manufacturers is suspected of violating the self-regulatory rules created by the industry group "Medical Equipment Industry Fair Trade Council" based on the prize labeling law, and with the Ministry of Health, Labor and Welfare. The council is investigating the details by receiving materials from the manufacturer.

Star Japan "reports to relevant authorities and industry groups and outsources investigations to external law firms. We take this situation seriously and cause concern and inconvenience to healthcare professionals, patients and families. We apologize for the inconvenience. "

Former employee "The aim was to secure a share"

One of the former employees of "Star Japan" who was interviewed by NHK said, "By giving a reward to the doctor, I preferentially purchase the company's lens" about the contract to pay cash to the doctor by receiving the surgical video. The aim was to secure a market share. I felt pressured that a major manufacturer would take away me if I didn't expand my market share, and it wouldn't be a viable business. It was one of the sales promotions. "

Regarding the video provided by the doctor, he said, "I explained to the doctor that I would use it as a teaching material in the company. I used it for screening on the homepage and academic conferences, but I think I didn't need much." ..

On top of that, "In the medical industry, the bad habit of entertaining doctors by eating, drinking, playing golf, etc. was rampant. Entertainment is gone now, but if the same effect is achieved, it is faster to give cash. Anyway, I want to increase sales. So, I was ignoring the patient. I think it was a bad thing now. "

How does cash provision to doctors work?

According to a private credit bureau, "Star Japan" is the main product of "intraocular lenses" used in cataract surgery, etc., and the adult sales are 3.8 billion yen.

With the aging of the population, the number of cataract surgeries is increasing in Japan, but competition with other companies has intensified in recent years.

According to multiple parties, "Star Japan" sold lenses until a few years ago, and then outsourced a questionnaire survey called "post-marketing survey" to medical institutions to confirm safety, and "survey outsourced". It means that he paid thousands of yen to the doctor for each operation as "expense".

However, the company's intraocular lenses for cataracts have been on the market for many years, and the "post-marketing surveillance" to confirm their safety has ended, and the "video campaign" for exchanging surgical videos about three years ago. Has begun.

In response to NHK's interview, one of the company officials said, "We couldn't continue to pay doctors a reward in the'post-marketing survey', and there was a risk that other companies would lose market share. It was a "video campaign" that came out when I needed it. I knew from that time that there was a risk in terms of compliance. "

The internal material titled "Video Campaign 2019" obtained by NHK lists the amount to be paid to the contracted doctor along with the number of lenses sold and the unit price.

This document also lists the amount of money that can be discounted per lens.

According to several company officials, they paid the doctor the amount of this amount multiplied by the actual number of units sold.

The amount that was originally supposed to be discounted was paid to the doctor.

One of the company officials said about the campaign, "Simply discounting will reduce sales for the company and there is no benefit to working doctors. By kicking back the actual discounts to doctors, sales will not drop. , I was able to secure the sales target. "

On the other hand, one of the doctors who had a contract with NHK commented, "I cooperated with the idea that it would be useful for the development of medical care, and I have never thought that the amount is large and small." doing.

Expert "Possibility of hitting a rebate"

Professor Shigeto Yonemura of the University of Tokyo, who is familiar with medical law, said, "It has been pointed out that there are cases where the relationship between pharmaceutical / medical device manufacturers and doctors exchanges money for some time, and the industry as a whole is working to optimize it. This time, the impression is gray, which is quite close to black. It may be a rebate that hides the surgical video. "

On top of that, "If the manufacturer pays the doctor a rebate, it will be passed on to the price of medicines and medical devices, so it will have to be compensated from the medical expenses paid by the patient. If the practice of rebate remains, in the end, Medical costs will be high, which is negative for the entire population. "

Regarding the future, "First of all, after properly investigating how many such transactions actually exist, what kind of measures can be taken, who will clarify and infiltrate the rules, and discuss. We need to go. "

Full comment of "Star Japan"

"Star Japan GK reports to the relevant authorities and industry groups in Japan and outsources an investigation into this program to an external law firm. The facts have been revealed and various investigations have been completed. At that point, we will introduce research-based recommendations and then provide an overview at the right time. This matter does not affect the health and safety of our patients or the treatment of our healthcare professionals. We take this situation seriously and apologize for causing concern and inconvenience to Japanese medical professionals, patients, and their families. This program has been discontinued due to investigation. ".