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As medical costs mount, Japan to weigh cost-effectiveness in setting drug prices

21 Comments
By Takashi Umekawa

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21 Comments
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That's a slippery slope to making medication a privilege to those deemed worthy enough of receiving it regardless of age.

0 ( +0 / -0 )

Not so worried about the increase in the cost of medical care as the society ages. Remember that the consumption tax is geared to pay for it, plus the government will be halved since the population to politician ratio will demand it. Then take the savings from stopping the LDP vote buying programs in support of whaling and rice growing - and there will plenty of money for all of the seniors to take ocean cruses at government expense. (End snark)

0 ( +0 / -0 )

Socialism is defined as state ownership of the means for producing government services. Japan does not have socialized medicine. Hospitals are a mix of public and private ownership. A large fraction of all Japanese doctors are in private practice and quite entrepreneurial. Drug companies and medical equipment companies are all privately owned. The largest drug and equipment manufacturers are multinational and have a significant level of foreign ownership. Takeda which just spent $62 billion to takeover Shire is headed by a foreign national.

This is very misleading to those who are unfamiliar with the system here in Japan. Yes, hospitals are a mix of public and private ownership, with private ownership being in the majority, However they ALL fall under the control and guidance of the government system that is in place.

You wont get seen at a private hospital if you dont have insurance, not to mention that everyone in the country is required to have some type of health insurance. Private hospitals and doctors can not import new drugs or medicines on their own, they ALL have to be approved for use and sale by the appropriate government ministry, and it takes years, if ever, for that to happen, as the medicines and drugs are developed and manufactured overseas and that cuts into the the local market.

If "newer more efficient medications" means drugs with a higher performance / cost ratio, the government has every incentive to facilitate their introduction. Japan is not alone in monitoring the performance / cost ratio of drugs. A number of countries do it including Canada and Britain. Nothing socialist about it.

Not necessarily as the local pharmaceuticals lose out on profits, and as mentioned previously "times visited" to a doctor or hospital, and "volume" of prescriptions filled, is how these corporations are making a killing in the market here.

1 ( +2 / -1 )

Each person will be rated with a level of importance, based upon your importance you will receive that levels medical availability....

Science Fiction, becomes Fact. .... -(

1 ( +2 / -1 )

This is more an article to make the reader think that the government is on the look out for their well being and keeping costs down for their benefits!

Yubaru, Spot on. I won't say government but rather bureaucrats as they are the ones formulating

policy and the brain dead LDP oyajis do nothing but pass them as laws.

And the bureaucrats are known to look out for companies rather than the citizens.

A good example of the scamming of the docile populace is the billing by months of admitted patients

rather than days. you stay one day in January and one day in February in the hospital and you for two months

and not two days even with medical insurance you will end up paying two hundred thousand yen and more.

-2 ( +0 / -2 )

The first time I had a root canal done here it took around 20 visits! When I lived in the US it took 2 visits. Now that's what I call milking the insurance system. About a year ago an eye doctor told my wife she had glaucoma and needed surgery; as fortune would have it, we were going to the US for a visit two weeks later so I took her to an ophthalmologist -- his diagnosis: no glaucoma but a mild stigmatism.

5 ( +5 / -0 )

If you ask whether it's worth prescribing an 85-year-old patient Opdivo, a lot of people will say no

They will soon change their mind when they become 85 and need the same drugs. How many people refuse these drugs on the grounds of the cost to taxpayers?

3 ( +3 / -0 )

Your dentist should have said ""That is how I BEST milk the insurance system""

7 ( +7 / -0 )

Scratch the surface and you will see why. Japanese doctors are loath to proscribe medications that can "cure" a patient in one visit! Get an ear infection here and see how many times it takes to go to the doctor to get cured! You'd be shocked!

Before I was enrolled to the shakai hoken, my dental visits used to be 1 or 2 times for a treatment. After enrolling, those visits increased 3x. The dentist told me that's the way the insurance works. Looks like it's the same with every other treatment here in Japan.

6 ( +6 / -0 )

public medical spending could surge 75 percent to 68.5 trillion yen by 2040.

That is when my kids will be in their 50's.

I sure don't want to hand that problem down to them.

gary

1 ( +2 / -1 )

As someone who works in the industry, the pharma companies are merely bloviating, releasing nothing but hot air. Japan is the second largest pharmaceutical market in the world with an ageing demographic which has a growing rate of chronic diseases which require ongoing treatment. You really think they are going to check out? Where are they going to go? What would they tell their shareholders?

It's ironic that the American industry spokesperson, apparently from a country that promotes capitalism (in reality profit maximisation), is concerned about the ultimate outcomes of such measures (i.e., greater competitive pressures).

Countries around the world (Australia, the UK, New Zealand) tie drug cost-effectiveness to ultimate decisions about listing a drug, the level of subsidy and the patient groups that will be eligible for treatment. Ageing populations in advanced economies is a worldwide problem and credit to the Japanese Government if this actually happens. I hope it is happening for all drugs being assessed.

I note some of the details, however, "ICER, already used in countries such as Britain, considers how much it costs to give a patient one additional year of healthy life compared with existing alternatives. If that exceeds 5 million yen, for example, the government may insist on a lower price, according the policy draft."

The UK Government's drug evaluation arm, the National Institute for Health and Care Excellence (NICE), has a incremental cost-effectiveness (ICER) threshold of approximately 30,000 pounds per QALY (i.e. one additional full year of life in perfect health); the Japanese Government's proposed threshold is therefore 15% more generous.

The problem with the Japanese medical industry is the power of clinicians - they are remunerated based on the number of contacts they have with patients.

5 ( +5 / -0 )

Interesting thread here! Meds are both a blessing & cures in Japan for sure.

The simple fact one CANNOT buy OTC meds for the common cold & flu is just nuts. Yes technically there are OTC meds but their strengths are so low to be pretty much placebos!

When I go home & bring back cold & flu meds for when the need arises so almost never end up in a docs office with the exception of dentists, now don't get me started on the idiotic world of J-dentistry...…

One of the biggest problems is doctors making $$ based on patient visits & drugs prescribed, the amount of time & $$ wasted by the masses on TOO MANY doc visits should really be looked into as the costs to people & businesses is MASSIVE in this regard & so unnecessary!

7 ( +8 / -1 )

What a scam the medical business is in Japan!

My doctor will instantly order x-rays and an MRI scan for my knee problems without even accessing my condition with an examination.

The last time I went I received 90 pain killing tablets too!

All of this is subsidized.

There isn’t a present cure for my condition so I’ll keep on getting the same again and again....

5 ( +5 / -0 )

Japan actually does have access to new medication. Easy access at that. The issue isn’t the access of the medication it’s that certain doctors choose not to offer those particular medications because of price.

Sure it does, if it chooses to import them, and certify them but they rarely do because of costs and it cuts into local pharmaceuticals profits. Japanese pharmaceuticals spend a fraction of their money on research and development because of the costs.

There are countless numbers of over the counter drugs sold in foreign countries that are ILLEGAL here in Japan because they need to fall under the national drug laws, hence they are not imported nor sold here, as they would need a doctors prescription!

You can not buy a "Red Bull" (Made in America) BECAUSE of the "illegal" drugs that are in the drink, it becomes a "medicine" here!

Insurance costs could go down drastically here with better access to over the counter medicines here!

8 ( +8 / -0 )

Medicines are controlled by the pharmaceutical companies and government here. Newer more efficient medications are held out of the market because of the socialized medicine system here!

Socialism is defined as state ownership of the means for producing government services. Japan does not have socialized medicine. Hospitals are a mix of public and private ownership. A large fraction of all Japanese doctors are in private practice and quite entrepreneurial. Drug companies and medical equipment companies are all privately owned. The largest drug and equipment manufacturers are multinational and have a significant level of foreign ownership. Takeda which just spent $62 billion to takeover Shire is headed by a foreign national.

If "newer more efficient medications" means drugs with a higher performance / cost ratio, the government has every incentive to facilitate their introduction. Japan is not alone in monitoring the performance / cost ratio of drugs. A number of countries do it including Canada and Britain. Nothing socialist about it.

5 ( +7 / -2 )

The market in Japan is far too lucrative to avoid because of a price cap. Japan is one of the top 4 countries in medication spending.

Scratch the surface and you will see why. Japanese doctors are loath to proscribe medications that can "cure" a patient in one visit! Get an ear infection here and see how many times it takes to go to the doctor to get cured! You'd be shocked!

Doctors proscribe the lowest level medicine first, and when symptoms persist they gradually increase doses., and keep the patients coming back.

I worked in a Japanese hospital for a decade, I have seen what I am talking about here first hand. Simple illnesses like a cold, take weeks to cure, because doctors do not proscribe medications that work efficiently nor fast. I could explain why, but it's bullsnit!

The market is lucrative because of volume only, That volume could be cut with better use of medicines that are on the market already in foreign countries!

11 ( +11 / -0 )

Japan actually does have access to new medication. Easy access at that. The issue isn’t the access of the medication it’s that certain doctors choose not to offer those particular medications because of price.

Japan is one of the most lucrative markets for pharmaceutical companies because Japan doesn’t control their price, the government works more on cost subsidization meaning that they pay a large amount of the cost to keep the drug cheaper. Drug companies love Japan and love introducing new medications to Japan.

1 ( +3 / -2 )

One thing I can agree with the government about is that the drug companies are bluffing.

The market in Japan is far too lucrative to avoid because of a price cap. Japan is one of the top 4 countries in medication spending.

Saying goodbye to Japan would be saying goodbye to billions and no drug company is that stupid especially because they are greedy.

7 ( +8 / -1 )

Japanese have easy access to new medicines, whose prices are decided by the government and subsidized by the country's public health insurance system.

Medicines are controlled by the pharmaceutical companies and government here. Newer more efficient medications are held out of the market because of the socialized medicine system here!

This is more an article to make the reader think that the government is on the look out for their well being and keeping costs down for their benefits!

7 ( +9 / -2 )

If people are going to be denied expensive treatments for any reason, but especially age, then give them the option of an unimpeded and painless death at the time of their own choosing. Why should governments make patients and their families suffer such indignities?

11 ( +11 / -0 )

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