This category covers 28 cases spanning 2018 to 2024. The structural pattern across them is consistent: representatives claimed superiority over competitors — citing safety advantages or distinguishing features — without presenting any direct head-to-head comparison data. The tactics vary: actively disseminating unfavorable information about biosimilars and generics, asserting safety superiority based solely on differences in mechanism of action, or using alarming language about a competitor's adverse event to pressure physicians into switching. The underlying failure is the same in every instance — the comparative claim lacks evidentiary support. Unsubstantiated comparisons may constitute exaggerated advertising prohibited under Article 66 of the PMD Act, and fall squarely within Prohibition No. 5 of the seven prohibited acts listed under Principle (2) of Part 1, Section 3 of the Promotional Activities Guidelines (hereinafter, the Guidelines): 'denigrating or defaming other medicinal products with respect to their quality, efficacy, and safety.'

Mio"Yui, after going through all 28 cases, what patterns stood out to you?"

Yui"There are a lot of explanations along the lines of 'safer than competitors' or 'superior to other agents.' In almost every case, no head-to-head comparison data was actually shown. I understand intuitively why that's a problem, but I find it hard to articulate precisely."

Mio"What would make a comparison permissible, in your view?"

Yui"Evidence, I suppose — clinical trial data generated under comparable conditions."

Mio"Exactly. Accuracy is one of the four requirements under Principle (1) of the Guidelines. Even if you name the comparator, the comparison isn't accurate without supporting data. Then Prohibition No. 5 under Principle (2) explicitly bans denigrating or defaming other products. Those two provisions work together."

Yui"In case 06-18, the representative used the phrase 'a feature our competitors couldn't achieve.' Does that fall under the same problem?"

Mio"It's a textbook example. It looks like a positive claim about the company's own product, but it's functionally disparaging the competitor. Indirect defamation like that tends to slip through review. You need to develop the habit of reading the implication behind promotional language, not just the surface wording."

Yui"Case 06-27 feels a bit different — the representative described an adverse event from a competitor's product as an 'abnormal situation' and used that to push physicians toward switching. Aren't they just citing a fact?"

Mio"Using part of a fact doesn't make the framing neutral. 'Abnormal situation' was chosen specifically to provoke anxiety. If emotionally charged language is selected to drive switching rather than to inform, that's defamation regardless of the underlying fact. It also connects to the issue of exaggeration that Article 66 of the PMD Act prohibits."

Yui"The cases involving biosimilars and generics — 06-01 and 06-02 — feel qualitatively different. The motivation seems more about protecting the originator product than attacking a direct competitor."

Mio"That's a good observation. But the regulatory assessment is the same regardless of motivation. Biosimilars and generics are 'other medicinal products,' and actively disseminating unsubstantiated unfavorable information about them falls under the prohibited acts. The originator-versus-generic distinction doesn't affect how the rules apply."

Yui"So in review, whenever a comparative claim appears, the first thing to confirm is whether the material actually includes data that substantiates it."

Mio"That's the starting point. And even when data is present, check whether it's from a direct comparison trial and whether patient backgrounds are comparable. Many cases — 06-14, for instance — assert a safety difference based solely on mechanistic differences. Mechanism is not a substitute for data. That's the line every reviewer has to hold."

28 real cases from the reports

06-01FY2018抗がん剤企業担当者による情報提供
What happenedAn MR for an oncology product proactively disseminated unfavorable information about biosimilars—including an unverified claim that the biosimilar was not approved overseas and remarks such as 'questionable efficacy' and 'poor purification'—across multiple institutions, without any prior inquiry. The information also included the false claim that switching to a biosimilar is prohibited.
MHLW viewThe company proactively and extensively provided information that was disadvantageous to biosimilars of the product (and to biosimilars in general).
Competency lostRisk Detection, Knowledge
Next moveRequest source documentation for each claim made, record on the spot any factually incorrect statements—especially the false claim that switching is prohibited—and assess whether escalation to the monitoring authority is warranted.
06-02FY2019そう痒症治療薬企業担当者による情報提供
What happenedAfter a hospital decided to switch to a generic drug for a pruritus treatment, the originator product's MR approached both the hospital and nearby dispensing pharmacies with the claim that the generic was being rejected in reimbursement reviews in other prefectures, urging reconsideration.
MHLW viewThe company proactively and extensively provided information that was disadvantageous to the generic drug of the product.
Competency lostRisk Detection, Knowledge
Next moveRequest specific evidence for the alleged reimbursement rejections (reviewing body, case count, dates); if no substantiation is provided, explicitly flag the claim as unverified and maintain the switch decision record accordingly.
06-03FY2019抗がん剤企業担当者による情報提供
What happenedWhen a healthcare institution was considering switching away from an oncology product, the MR stated that other facilities had reverted to the original product due to adverse events after switching, without providing any details of the supposed investigation.
MHLW viewThe company provided information that was disadvantageous to a competitor's product that was being considered as a switch from the product.
Competency lostRisk Detection, Knowledge
Next moveAsk for the facility names, event details, and any investigation report; if the MR cannot provide them, document the refusal and exclude the claim from the switching decision process.
06-04FY2019パーキンソン病治療薬企業担当者(MR)による口頭説明
What happenedAn MR for a Parkinson's disease patch product verbally asserted that their product offered superior skin feel compared to a competitor's, despite the absence of any comparative data to support the claim.
MHLW viewThe company claimed that its own product was superior to a competitor's equivalent drug without any comparative data to support that claim.
Competency lostKnowledge, Risk Detection
Next moveRequest the comparative data supporting the superiority claim; if none exists, document it as an unsupported comparative statement and require evidence-backed materials as a condition for future information sessions.
06-05FY2019COPD 治療薬プレゼンテーション用スライド、企業担当者による口頭説明
What happenedAn MR for a COPD treatment used a slide stating that 'virtually all patients with asthma-complicated COPD are candidates for this drug,' while providing no verbal explanation of the associated risk of increased pneumonia incidence.
MHLW viewThe company provided information that emphasized efficacy only, without explaining adverse reactions.
Competency lostRisk Detection, Knowledge
Next moveCross-check the slide content against the package insert's adverse reaction section (pneumonia risk), document the omission, and formally request the company to provide a supplementary safety briefing.
06-06FY2019慢性便秘症治療薬医療関係者向け情報サイト上の Web 講習会
What happenedA web lecture on a chronic constipation treatment emphasized efficacy in elderly patients while omitting safety information, despite the regulatory review report requiring careful observation in that population due to insufficient safety data.
MHLW viewDespite the review report and other documents taking the stance that sufficient observation with attention to the occurrence of adverse reactions was necessary, the company provided information emphasizing efficacy only, without providing such information on safety.
Competency lostKnowledge, Risk Detection
Next moveCompare the web lecture content with the regulatory review report and package insert, identify the missing safety cautions for elderly patients, document them, and request supplementary materials from the company.
06-07FY2019腎性貧血治療薬企業担当者による口頭説明
What happenedWhen asked about the malignancy risk listed in the RMP of a renal anemia drug, the MR responded that a competitor's RMP contained a similar notation and therefore the risk was not a significant concern, effectively dismissing the product-specific risk by comparison.
MHLW viewThe company cited another drug to imply that the risks associated with the product were not a significant concern, thereby downplaying safety.
Competency lostRisk Detection, Communication
Next moveMake clear that citing a competitor's risk notation does not constitute an adequate safety evaluation, and separately request written confirmation of the product's specific risk magnitude, frequency, and management approach.
06-08FY2019抗アレルギー薬企業サイト上の Web 講習会
What happenedA 20-minute company-hosted web lecture on an antiallergic drug made no mention of key precautions or contraindications; the only safety content was a 10-second projection of the package insert at the end of the session.
MHLW viewIn a web-based training session on the company's website, the explanation of safety information — including important precautions and contraindications — was limited to a brief projection of the package insert, resulting in information provision that was skewed toward efficacy.
Competency lostRisk Detection, Knowledge
Next moveDocument the session's time allocation and treatment of safety items; note that projecting the package insert for ten seconds does not satisfy the information provision obligation, and formally notify the company.
06-09FY2019パーキンソン病治療薬企業担当者による提供資料
What happenedAt a product briefing for a Parkinson's disease treatment, the MR did not cover the appropriate-use guides and related materials specified in the risk minimization plan of the RMP, leaving safety information materially incomplete.
MHLW viewThe risk minimization measures specified in the Risk Management Plan (RMP) — namely, information provision via the package insert and the Patient Medication Guide — were not implemented, resulting in insufficient explanation of safety.
Competency lostKnowledge, Risk Detection
Next moveVerify whether the RMP-specified risk minimization activities (including the appropriate-use guide) were covered; if not, document the omission and formally request the company to fulfill those obligations.
06-10FY2019慢性心不全治療薬企業担当者による提供資料
What happenedAt a product briefing for a chronic heart failure treatment, the explanation of risk-benefit considerations for eligible patients and potential risks was insufficient, and implementation of the RMP risk minimization plan was also inadequate.
MHLW viewInformation provision based on the RMP and explanation of specific eligible patients were insufficient.
Competency lostKnowledge, Risk Detection
Next movePrepare a checklist covering both risk-benefit information for eligible patients and RMP implementation status; after the briefing, record any unaddressed items and request a supplementary explanation from the company.
06-11FY2020DMD 治療薬対面の面談にて、企業担当者による資料提供
What happenedAn MR for a DMD treatment described the drug as having 'high safety' based solely on the absence of adverse events in a clinical trial, without reference to the trial's size, duration, or other contextual factors.
MHLW viewThe company explained that the product had a high safety profile solely on the grounds that no adverse events were observed in clinical trials.
Competency lostKnowledge, Risk Detection
Next moveReview the trial's sample size, follow-up duration, and evaluation methodology; document that absence of adverse events is not accepted as positive proof of safety, and cross-check with the package insert's safety section.
06-12FY2020抗菌薬オンラインのグループ面談にて、企業担当者による説明
What happenedDuring an online group meeting on an antibacterial drug, the slide materials listed only ingredient names, but the MR's verbal explanation repeatedly cited specific competing brand names when making comparisons with the promoted product.
MHLW viewWhen comparing the product with a competitor's product, the company specifically named the competitor's product by its brand name.
Competency lostKnowledge, Risk Detection
Next moveRecord the fact that specific competitor brand names were cited verbally, flag the discrepancy between the slide materials and oral presentation, and simultaneously verify whether supporting comparative data was provided.
06-13FY2020腎性貧血治療薬オンライン面談にて、企業担当者による説明
What happenedDuring an online meeting about a renal anemia drug, a company representative stated that the product was safer than competing drugs because no adverse reactions had been observed in domestic clinical trials — despite the absence of any comparative safety data. The claim exploited a single observed fact to assert an unsupported superiority over other drugs.
MHLW viewOnly the absence of adverse reactions in the clinical trial was emphasized, and the product was described as safer than other drugs.
Competency lostKnowledge, Risk detection
Next movePoint out that 'no adverse reactions observed' and 'safer than other drugs' are distinct claims, then request clarification on whether any head-to-head safety trial exists and ask the representative to retract the comparative statement.
06-14FY2020腎性貧血治療薬オンライン面談にて、企業担当者による説明
What happenedIn an online meeting on a renal anemia drug, the representative used a slide comparing the product with Drug A but then extended the comparison to Drug B — claiming a more gradual hemoglobin rise — based solely on pharmacological mechanism, with no quantitative clinical data to support the comparison.
MHLW viewSuperiority over other drugs was claimed based solely on differences in pharmacological mechanism of action.
Competency lostKnowledge, Risk detection
Next moveConfirm that a difference in pharmacological mechanism does not automatically translate to clinical superiority, ask whether quantitative comparative data for Drug B exists, and if not, request withdrawal of the claim.
06-15FY2020眼科用 VEGF 阻害剤オンライン面談にて、企業担当者による説明
What happenedIn an online meeting on an ophthalmic VEGF inhibitor, the representative covered only secondary endpoints that reached statistical significance, with no slides and no verbal explanation of the primary endpoint. The information provided was structurally skewed toward favorable results.
MHLW viewOnly secondary endpoints that showed statistical significance were explained, while the primary endpoint was not addressed.
Competency lostKnowledge, Communication
Next moveRequest the primary endpoint results and ask why no materials were prepared for them. State explicitly that secondary endpoints alone do not allow a full assessment of the trial, and ask for supplementary materials that include the primary endpoint.
06-16FY2021片頭痛予防薬オンライン面談時における企業担当者の説明(企業担当者の上司同席)
What happenedDuring an online hearing on a migraine preventive drug, the representative voluntarily raised dosing drawbacks of Competitor A and a constipation concern with Competitor B — neither topic had been asked about — to promote the company's own product. A supervisor was also present, suggesting the behavior may have been organizational rather than individual.
MHLW viewOther companies' products were disparaged without basis, and the superiority of the company's own product was promoted.
Competency lostRisk detection, Relationship building
Next moveFlag each unsolicited negative claim about competitor products and request the scientific basis for each statement. Document the supervisor's presence and note in the adverse report the possibility of organizational involvement.
06-17FY2021糖尿病治療薬製品パンフレット
What happenedA product brochure for a diabetes drug presented the results of a domestic phase III trial — designed primarily to evaluate safety — by placing secondary endpoint (efficacy) results first and primary endpoint (safety) results second, creating the impression that efficacy was the main finding. The same reordering appeared on the company's website for healthcare professionals and in the interview form.
MHLW viewThe product was studied in a clinical trial designed and conducted in accordance with the 'Guidelines for Clinical Evaluation of Oral Hypoglycemic Agents,' in which safety was the primary objective. Nevertheless, the product pamphlet presented secondary endpoint results (efficacy) first, thereby emphasizing efficacy. Results from clinical trials designed to evaluate efficacy should be presented first.
Competency lostKnowledge, Risk detection
Next moveCiting the guideline requirement that safety was the primary endpoint, send a written request to the company to revise the order of presentation in the brochure and to apply the same correction to the website and interview form.
06-18FY2021腎性貧血治療薬企業担当者による説明
What happenedDuring a hospital visit to discuss a renal anemia drug, the representative accurately described clinically proven iron utilization benefits but added that this was 'a characteristic competitors could not achieve,' directly referencing other companies without any supporting data.
MHLW viewAn explanation was provided that disparaged other companies.
Competency lostRisk detection, Communication
Next moveAsk for the supporting data behind the claim about competitors; if none exists, request the representative retract the statement and advise that factual product descriptions and competitor comparisons must be kept separate.
06-19FY2021片頭痛予防薬オンライン面談時における企業担当者の説明
What happenedIn an online meeting on a migraine preventive drug, the representative explained that competitor products require a loading dose while their own product does not, then characterized this as being 'clinically superior.' The presence or absence of a loading dose reflects a difference in dosing protocol, not a validated measure of clinical benefit.
MHLW viewA difference in dosing regimen was described without substantiation as 'clinically superior,' thereby emphasizing the superiority of the company's own product.
Competency lostKnowledge, Risk detection
Next moveAsk for the basis of the 'clinically superior' claim and verify whether the absence of a loading dose is directly linked to clinical outcome data on efficacy or safety. If no such data exists, request the statement be withdrawn.
06-20FY2021心不全治療薬オンライン面談時における企業担当者の説明
What happenedAt an online information session on a heart failure drug, the representative presented only the overseas phase III trial results that showed significant differences, making no mention of the domestic phase III trial that failed to show significance. The same pattern was confirmed at multiple institutions.
MHLW viewOnly selectively favorable overseas Phase III trial results showing statistical significance were presented, while domestic Phase III trial results that did not achieve statistical significance were not addressed at all, resulting in biased information provision that emphasized efficacy. In particular, the domestic Phase III trial, which constitutes an important evaluation document at the time of approval review, must be mentioned.
Competency lostKnowledge, Risk detection
Next moveRequest disclosure of the domestic phase III trial results and ask why they were omitted. State clearly that results from domestic trials — which are key evidence in the approval review — cannot be omitted, and document the multi-site pattern in an adverse report.
06-21FY2021血圧降下剤スポンサー企業が情報サイト会社にて開催するオンラインセミナーの動画コンテンツ
What happenedAt a sponsored online seminar, a speaker presented subgroup analysis results focused on a specific symptom within the approved indication of an antihypertensive drug and emphasized efficacy for patients with that symptom. The analysis had not been discussed in the review report or original papers, risking the impression that clinical utility had been formally established for that subgroup.
MHLW viewSubgroup analysis results not discussed in the review report or original publication were presented, and the efficacy of the drug for patients with a specific symptom of the approved indication was emphasized. It should be noted that lecture slides and similar materials by speakers associated with the sponsoring company must be reviewed by the sponsoring company.
Competency lostKnowledge, Risk detection
Next moveVerify whether the subgroup analysis appears in the review report or published paper; if not, flag to the sponsor company that its pre-lecture slide review process failed to catch this. Request documentation of the slide approval workflow.
06-22FY2022その他の腫瘍用薬企業担当者による説明(オンライン)
What happenedDuring an online meeting on a cancer drug, the representative named a competitor product and stated 'they have not achieved data at this level,' then asked the healthcare professional how they viewed that fact — without presenting any head-to-head comparison data. The issue was the deliberate attempt to elicit a disparaging opinion about the competitor from the healthcare professional rather than stating it directly.
MHLW viewIt is inappropriate to provide information in a manner intended to elicit disparaging comments about competing products from healthcare professionals.
Competency lostRisk detection, Sixth sense
Next moveRecognize the leading nature of the question, confirm whether any direct comparative data exists, and if not, ask the representative to limit the discussion to the company's own data. Document the attempted elicitation of disparaging comments.
06-23FY2023耳鼻科用剤企業担当者による説明(オンライン)
What happenedDuring a new-drug hearing for an ear-nose-throat product, the representative stated that competing antibacterials raised concerns about resistance development, but no susceptibility data supported the claim. When questioned, the representative acknowledged that surveillance data tracking the antimicrobial activity of the competitor product over time did not exist.
MHLW viewInformation was provided that appeared to disparage a competing product without any supporting evidence.
Competency lostKnowledge, Risk detection
Next moveRequest the susceptibility surveillance data underlying the resistance concern; if none exists, ask the representative to retract the statement and clarify that raising concerns about a competitor product without evidence constitutes disparagement.
06-24FY2023漢方製剤企業担当者による説明(直接対面)
What happenedDuring a face-to-face product explanation for a Kampo preparation, the representative claimed that a specific ingredient absent from competitor products had antidepressant effects. When asked for evidence, the representative acknowledged the basis was animal experiment data only, with no human efficacy data available.
MHLW viewInformation was provided that appeared to disparage competing products despite the absence of comparative data with those products.
Competency lostKnowledge, Communication
Next moveRequest that animal and human data be clearly distinguished in any explanation, and note that implying human efficacy when only animal data exists is inappropriate. Ask that future explanations specify the level of evidence upfront.
06-25FY2023抗ウイルス剤電子メールによる DM
What happenedA MR promoting an antiviral drug mass-distributed an email that omitted most of the drug's own interaction data from a hepatology society guideline table while selectively presenting competitor interaction data. The email also claimed the drug was easier to use in polypharmacy patients due to fewer interactions without providing scientific evidence for that comparison.
MHLW viewThe company provided information that emphasized comparisons with competitors' products in order to promote the superiority of its own product.
Competency lostKnowledge (absence of scientific basis due to selective manipulation of the cited table), Risk detection (failure to recognize that biased information could distort prescribers' clinical judgment)
Next moveWhen reviewing materials that cite published sources, verify completeness against the original document and confirm that data for both the company's own product and comparators are presented on equal terms.
06-26FY2024混合生物学的製剤(ワクチン)企業担当者による説明(オンライングループ面談(院内))
What happenedWithout being asked by the healthcare provider, a vaccine MR highlighted that a competitor product (Agent B) required reconstitution as a vial-syringe combination, implying it was inferior to the company's ready-to-use syringe product (Agent A). Information unfavorable to Agent A, such as its shorter shelf life, was withheld, making the comparison one-sided.
MHLW viewComparative information on pharmaceutical formulations is necessary for healthcare professionals, and it is acknowledged in the 'Q&A on the Guidelines for Promotional Activities for Prescription Drugs (Part 4)' that companies may explain comparisons between their own and competitors' products when requested by healthcare professionals. However, the information provided must not selectively present only information that is disadvantageous to competitors' products.
Competency lostKnowledge (insufficient understanding of the guideline requirement to provide balanced comparative information), Communication (selective omission of unfavorable data that distorted the healthcare provider's decision-making)
Next moveWhen reviewing comparative materials or verbal explanations, check that unfavorable aspects of the company's own product are disclosed alongside those of competitor products, and confirm no selective omission has occurred.
06-27FY2024他に分類されない代謝性医薬品企業担当者による説明(対面)
What happenedA MR for a metabolic drug visited a medical institution to report a rumor that two patients in the prefecture had experienced adverse events requiring surgery while using a competitor product (Agent B), and pressed the facility to switch to the company's product (Agent A), characterizing the unverified events as an 'abnormal situation' despite no confirmed causal link to Agent B.
MHLW viewThe MR described an adverse event that had occurred with a competitor's product as an 'abnormal situation' and appealed for a switch to the company's own product. This constitutes inappropriate promotional activity under the MSA Guidelines (Promotional Activity Guidelines), falling under the provisions prohibiting 'arbitrarily inducing the prescription or use of a specific prescription drug without scientific or objective basis' and 'disparaging or defaming competitors' products in order to claim the superiority of one's own product.'
Competency lostIntelligence (treating unverified rumor as fact and presenting it to a medical institution), Risk detection (failure to identify that disseminating causally unconfirmed information constitutes defamation of a competitor)
Next moveWhen reviewing materials or verbal explanations that include information about adverse events with competitor products, always verify the causal relationship and the scientific credibility of the source, and reject any claim lacking objective evidence.
06-28FY2024抗悪性腫瘍剤企業担当者による説明(直接対面)
What happenedDuring a product presentation for an antineoplastic agent, a medical science liaison stated that a competitor product (Agent A) caused severe myelosuppression requiring G-CSF, while claiming the company's product caused almost no myelosuppression. The company's own product, however, lists myelosuppression as a serious adverse reaction in its package insert, making the comparison a selective extraction of only favorable safety data.
MHLW viewOnly the points among the side effects that were favorable to the company's own product were selectively extracted to assert that product's superiority.
Competency lostKnowledge (proceeding with the explanation without accurate understanding of the product's own serious adverse reactions), Risk detection (failure to recognize that selective presentation of adverse reaction data constitutes competitor defamation and safety minimization)
Next moveWhen reviewing materials containing adverse reaction comparisons, cross-check explanation content against the serious adverse reactions listed in the company product's package insert, and verify that no cherry-picking of favorable data points has occurred in the comparison with competitor products.

The Anatomy of Failure ── All 8 categories

  1. 01. Promotion of Unapproved or Off-Label Indications and Dosage (33 cases)
  2. 02. Claims Lacking Evidence or Scientific Basis (69 cases)
  3. 03. Cherry-Picking, Data Manipulation, and Selective Presentation (33 cases)
  4. 04. Exaggerated and Misleading Expressions (28 cases)
  5. 05. Emphasizing Efficacy While Downplaying Safety (22 cases)
  6. 06. Disparagement and Defamation of Competitors' Products (28 cases) (this category)
  7. 07. Undisclosed Conflicts of Interest and Improper Conduct in Lectures and Prescribing Guidance (10 cases)
  8. 08. Cross-Category Violations Rooted in Process Failures (4 cases)
Key points
  1. Claiming superiority or inferiority relative to a competitor's product without head-to-head trial data can violate both Prohibition No. 5 (defamation) under Principle (2) of the Guidelines and the accuracy requirement under Principle (1).
  2. Mechanistic differences, single-institution data, or individual opinions do not constitute adequate evidentiary basis for comparative claims; reviewers must verify whether direct comparative data is actually present in the material.
  3. Actively disseminating unfavorable information about biosimilars or generics, or using alarming language such as 'abnormal situation' to drive switching, is subject to the same regulatory assessment as direct competitor defamation, regardless of stated intent or linguistic form.
Sources
  1. MHLW, "Monitoring Project on Promotional Information for Prescription Drugs — Annual Reports" (FY2016–2024).
  2. PMD Act, Article 66 (Prohibition of Exaggerated Advertising)
  3. Guidelines, Part 1, Section 3, Principle (2): Seven Prohibited Acts, Prohibition No. 5 (Prohibition of denigrating or defaming other medicinal products)
  4. Guidelines, Part 1, Section 3, Principle (1): Four Requirements (accurate and appropriate information provision)