RESULTS
As of November 15, 2021, we identified 307 PHOs certificated by JSPHO. Among all, 215 (70.0%) PHOs received a total of $908,900 from 54 pharmaceutical companies between 2016 and 2019 (Supplemental Material 1). The total cases and amounts of payments were 1,383 cases and $908,900 (Table 1). Average and median of four-years combined total payments per physician were $2,961 (standard deviation: $6,299) and $596 (interquartile ranges (IQR): $0‒$2,436). The Gini index was 0.769 for the four-year combined total payments. While the prevalence of physicians with payments was relatively stable during the study period with 40.4% and 44.6% in 2016 and 2019, the average annual personal payments increased nearly double from $559 in 2016 to $1,096 in 2019, respectively (Table 1 and Supplemental Material 1). Payments from the top five companies with the largest total payments accounted for 48.8% of total monetary values (Table 2).