The Japanese market and its healthcare system are quite unique. Here we would like to list some basic information regarding the Japanese healthcare system and its characteristics. Please do not hesitate to contact us if you need any further information.
Below are some of the major characteristics of the Japanese healthcare system.
Drug approvals are controlled exclusively by the national government (Ministry of Health, Labor, and Welfare: MHLW), and they would give a strict usage protocols (indications) for each drug they approve. As long as the drugs are used within this "approved indication", they are reimbursable.
Health insurance system
We have a universal health insurance system, in which all Japanese citizens are mandated to enroll. Depending on the patient's age and income, the copayment rate can range from 10-30%.
The copayment rate as of April 2008 as follows:
- Pre-elementary school (<5 years old) = 20% copayment
- Elementary school (6 years old) to age 69 = 30% copayment
- Age 70 or above = 10% copayment (30% if standard annual income*)
*Standard annual income = (single) 3.83 million Yen / (married) 5.2 million Yen
Medical facility types
There are two classifications of medical facilities in Japan; hospitals (20 beds or more) and clinics (less than 20 beds). Almost all clinics and little over 80% of hospitals are privately owned vs. government owned. (For number of hospitals/clinics in Japan, please see "Gateway to Asia" page).
We do not have a "specialist certification" or "board certification" system in Japan. After passing the national exam and completing 2 years of general clinical training, they are free to enter whatever specialty they choose - and thus begin their on-the-job training and education in that specialty.
Although we do not have a universal specialist certification system, you can become a "society certified specialist" by passing the exams of relevant academic societies in Japan. However, this certification is not necessary to be called a "specialist" in Japan.
Similarly, we do not have "oncologists" in Japan, and cancer is treated in regard to the location of the tumor (such as, pulmonologists = lung cancer, GI surgeons = stomach cancer, urologists = prostate cancer). In the meantime, the same physician/surgeon will be treating other non-cancer conditions in the relative area as well.
The nurses in Japan have much smaller responsibilities compared to oversea nurses, more specifically; the Japanese nurses do not have any prescribing or decision making responsibilities.
The patients in Japan are free to visit any type of medical facilities as they prefer; in other words, no referrals are necessary for them to visit major / specialized hospitals (although they may have to pay additional fees without referrals). Similarly, the patients are free to directly visit any type of specialists they wish.
DTC (direct to consumer) advertising of Rx products is not allowed in Japan. Thus it is uncommon for patients in Japan to ask physicians for specific "brands".