Why has the use of health economic evaluation in Japan lagged behind that in other developed countries?
The aging population and the increasing availability of new medical technologies, particularly pharmaceuticals, have led to growing pressure on governments worldwide to contain healthcare costs. Increasingly, economic evaluation is used to aid decisions on the reimbursement and formulary access of drugs, and pharmaceutical companies are often required to demonstrate the cost effectiveness of their products. Canada and the UK are examples of countries that have successfully incorporated mandatory requirements for economic evaluations into the decision-making process in healthcare. Japan faces cost-containment issues for its health and welfare system similar to those seen elsewhere in the world. Despite this, economic assessments are not currently used in the allocation of drug budgets. Reasons why economic evaluations for healthcare have not yet been used routinely in Japan include governmental approaches to healthcare cost containment, the pricing of pharmaceuticals, the organisation of the healthcare system, attitudes of the medical profession, and limited knowledge and expertise. However, small but encouraging steps are now being taken towards the introduction of economic evaluations in Japanese medicine.
Ikegami
Naoki
N
Department of Health Policy & Management, School of Medicine, Keio University, Tokyo, Japan. ikegama@sc.itc.kio.ac.jp
Drummond
Michael
M
Fukuhara
Shunichi
S
Nishimura
Shuzo
S
Torrance
George W
GW
Schubert
François
F
D002170:Canada; D003363:Cost Control; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics*; D017850:Economics, Pharmaceutical; D004739:England; D006801:Humans; D007564:Japan; D014852:Wales