The economic recession that has gripped Japan for a decade, along with increasing healthcare costs and the prospect of a shrinking workforce relative to a growing number of retirees, has created a universal health insurance crisis in Japan.  The country’s healthcare expenditures are forecast to increase from approximately $290.65 billion in 1997 to an estimated $1 trillion by the year 2020.

Approximately one-third of national medical expenditures are for the care of people over the age of 65.  As Japan’s population continues to age, medical expenditures are expected to continue to increase.  With healthcare cost constraints and the consolidation of delivery sites, manufacturers of medical devices are expected to see increasing competition for sales in the Japanese marketplace.

Japan’s economy is now beginning to show some faint signs of recovery, with the country’s new public nursing care insurance program contributing to the stimulation of relevant and new private healthcare sector services.  Provided in this report by Medtech Insight is a detailed overview of Japan’s demographics, healthcare system, medical markets, and governmental standards—information that is critical for medical device companies planning to market effectively in Japan.

Major topics include:  healthcare delivery; healthcare funding; healthcare system; population and demographics; economy; healthcare expenditures; incidence of diseases and disorders; healthcare product markets; and purchasing and distribution system.

TABLE OF CONTENTS

1. NATIONAL OVERVIEW

1.1 Population and Demographics

1.2 Political System

1.3 Economy

2. HEALTHCARE SYSTEM

2.1 Health Insurance Funding, Premiums, and Reimbursement Rates

2.1.1 Government-Managed Employee Health Insurance

2.1.2 Association-Managed Employee Health Insurance

2.1.3 National Health Insurance

2.1.4 Public Fees

2.2 Private Insurance

2.3 Patient Referrals

2.4 Healthcare Expenditures

3. HEALTH OF THE NATION

3.1 Infant Mortality Rate

3.2 Fertility, Marriage, and Divorce Rates

3.3 Life Expectancy

3.4 Leading Causes of Death

3.5 Incidence of Diseases and Disorders

3.5.1 Cancer

3.5.2 Human T-Cell Lymphotropic Virus

3.5.3 Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome

3.5.4 Leprosy

3.6 Selected Procedures

3.6.1 Abortion

3.6.2 Organ Transplantation

3.6.3 Bone Marrow Transplantation

3.7 Hospital Admissions and Discharges

4. HEALTHCARE DELIVERY

4.1 Hospitals

4.1.1 Specialty

4.1.1.1 Cancer Centers

4.1.1.2 Acquired Immunodeficiency Syndrome Centers

4.1.2 Long-Term Care

4.2 Medical Clinics

4.3 Outpatient Surgery Centers

4.4 Clinical Testing Laboratories

4.5 Gene Therapy Centers

5. MARKETS AND TRADE

5.1 Healthcare Product Imports and Exports

5.2 Healthcare Product Markets

5.2.1 Medical Devices

5.2.1.1 Bone Density Analyzers

5.2.1.2 Intravascular Ultrasound Devices

5.2.1.3 Prosthetic Vascular Grafts

5.2.1.4 Clinical Laboratory Equipment and Supplies

5.2.2 Pharmaceuticals

5.2.2.1 Generics

5.2.2.2 Vaccines

5.2.2.3 Orphan Drugs

5.2.2.4 Research and Development Expenditures

6. HEALTHCARE PERSONNEL

6.1 Physicians

6.2 Nurses

6.3 Dentists

6.4 Pharmacists

6.5 Other Healthcare Personnel

7. PURCHASING AND DISTRIBUTION

7.1 Medical Devices

7.1.1 Standards and Approvals

7.1.1.1 Japanese Industrial Standards

7.1.2 Purchasing Structure and Methodologies

7.1.3 Maintenance and Service

7.2 Pharmaceuticals

7.2.1 Drug Development and Marketing Approval

7.3 Product Liability

7.4 Patents, Trademarks, and Copyrights

7.5 Distribution/Sales Structure for Medical Products

7.6 Tax Increases

7.7 Initial Public Offering Market

APPENDIX A:    NATIONAL HEALTHCARE-RELATED                           ORGANIZATIONS

APPENDIX B:    NATIONAL TRADE ASSOCIATIONS

APPENDIX C:    MEDICAL ASSOCIATIONS

APPENDIX D:    NATIONAL HEALTH INSURANCE ORGANIZATIONS

APPENDIX E:    SELECTED PRIVATE COMPANIES THAT OFFER MEDICAL INSURANCE

APPENDIX F:    MEDICAL PRODUCT TESTING AGENCIES

APPENDIX G:    SELECTED PRIVATE CLINICAL TESTING LABORATORIES

APPENDIX H:    UNIVERSITIES WITH MEDICAL SCHOOLS

APPENDIX I:     HOSPITALS THAT PERFORM SPECIAL FUNCTIONS

APPENDIX J:    CANCER CENTERS AND HOSPITALS WITH CANCER-TREATMENT DEPARTMENTS

APPENDIX K:    SPECIALTY HOSPITALS

APPENDIX L:    PHARMACEUTICAL/BIOTECHNOLOGY                           MANUFACTURERS AND DISTRIBUTORS

APPENDIX M:   MEDICAL DEVICE MANUFACTURERS AND DISTRIBUTORS

LIST OF EXHIBITS

Exhibit 1-1:    2000, Japan, Prefectures and Capitals 

Exhibit 1-2:    1999, Japan, Selected Facts and Figures 

Exhibit 1-3:    Japan, Population Distribution, by Age, 1995-1999 

Exhibit 1-4:    Japan, Male Population Distribution, by Age, 1995, 1996, 1997, 1998, and 1999 

Exhibit 1-5:    Japan, Female Population Distribution, by Age, 1995, 1996, 1997, 1998, and 1999 

Exhibit 1-6:    1998, Japan, Population Distribution, by Region 

Exhibit 1-7:    1998, Japan, Population Distribution, by Prefecture 

Exhibit 1-8:    Japanese Companies, Bankruptcy and Debt Totals, 1998 and 1999 

Exhibit 1-9:    Japan, Key Economic Indicators, 1996-2000 

Exhibit 2-1:    1998, Summary of Japanese Health Insurance Programs 

Exhibit 2-2:    Sources of Government-Managed Employee Health Insurance Funding in Japan, 1996-1998 

Exhibit 2-3:    Japanese Government-Managed Employee Health Insurance Expenditures, by Type, 1996-1998 

Exhibit 2-4:    Sources of Association-Managed Employee Health Insurance Funding in Japan, 1996 and 1997 

Exhibit 2-5:    Japanese Association-Managed Employee Health Insurance Expenditures, by Type, 1996 and 1997 

Exhibit 2-6:    Sources of National Health Insurance Funding in Japan, 1996 and 1997 

Exhibit 2-7:    National Health Insurance Program Expenditures in Japan, by Type, 1996 and 1997 

Exhibit 2-8:    National Healthcare Expenditures in Japan, 1996 and 1997 

Exhibit 2-9:    1997, National Healthcare Expenditures in Japan, by Type of Treatment 

Exhibit 3-1:    1997, Infant Mortality in Japan, by Cause of Death 

Exhibit 3-2:    1997, Reported Causes of Death in Japan 

Exhibit 3-3:    1997, Cancer Deaths in Japan, by Site of Origin 

Exhibit 3-4:    1998, Number of Outpatients Treated in Japan for Commonly Diagnosed Diseases or Conditions 

Exhibit 3-5:    1998, Human Immunodeficiency Virus Prevalence in Japan, by Route of Transmission 

Exhibit 3-6:    1996, Selected Surgeries in Japan, Procedure Volumes 

Exhibit 3-7:    1999, Patients Requiring Organ Transplantation in Japan 

Exhibit 3-8:    2000, Approved Facilities for Organ Transplantation in Japan 

Exhibit 3-9:    1999, Bone Marrow Transplantations Performed through the Japanese Bone Marrow Bank 

Exhibit 3-10:  1997, Daily Average Number of Inpatients in Japan, by Hospital Type 

Exhibit 3-11:  1996, Average Daily Number and Distribution of Treated Outpatients in Japan, by Disorder 

Exhibit 3-12:  Average Patient Length-of-Stay in Japanese Hospitals, by Type of Hospital, 1996 and 1997 

Exhibit 4-1:    1997, Japanese Hospitals, by Ownership and Type 

Exhibit 4-2:    1997, Japanese Hospitals, by Number of Beds 

Exhibit 4-3:    1997, Number of Hospital Beds in Japan, by Hospital Type 

Exhibit 4-4:    1997, General Medical Clinics in Japan, by Ownership and Bed Status 

Exhibit 4-5:    1997, General Clinic Beds in Japan, by Clinic Ownership 

Exhibit 4-6:    1998, Annual Domestic Production of In Vitro Diagnostic Reagents in Japan 

Exhibit 4-7:    1997, Annual Cost of Clinical Laboratory Tests to Japanese Hospitals and Clinics 

Exhibit 4-8:    1998, Leading Clinical Testing Laboratories in Japan 

Exhibit 4-9:    2000, Selected Japanese Biotechnology Research Projects 

Exhibit 4-10:  2000, Selected Japanese Gene Therapy Research Projects 

Exhibit 5-1:    1998, Japanese Medical Device Exports 

Exhibit 5-2:    1998, Medical Devices Imported Into Japan 

Exhibit 5-3:    1998, Types of Medical Devices for Which Japan is Dependent on Imports 

Exhibit 5-4:    1998, Japanese Pharmaceutical Exports 

Exhibit 5-5:    1998, Pharmaceuticals Imported Into Japan 

Exhibit 5-6:    1998, A Comparison of Domestically Produced and Imported Medical Devices in Japan 

Exhibit 5-7:    1996, Selected Medical Devices, Installed Base in Japanese Hospitals 

Exhibit 5-8:    1996, Selected Medical Devices, Installed Base in Japanese Medical Clinics 

Exhibit 5-9:    1998, Domestically Produced and Imported Prescription Pharmaceuticals in Japan 

Exhibit 5-10:  1998, Production and Supply Volumes of Selected Vaccines Made in Japan 

Exhibit 5-11:  1998, Research and Development Budgets of Selected Japanese Pharmaceutical Companies 

Exhibit 6-1:    1996, Number of Physicians Serving in Healthcare Facilities in Japan, by Specialty 

Exhibit 6-2:    1996, Number of Physicians in Japan, by Practice Site and Employment Status 

Exhibit 6-3:    1996, Registered and Licensed Practical Nurses in Japan, by Practice Site 

Exhibit 6-4:    1996, Dentists in Japan, by Practice Site and Employment Status 

Exhibit 6-5:    1996, Pharmacists in Japan, by Practice Site and Employment Status 

Exhibit 7-1:    Medical Device Manufacturing Licenses Granted and Products Approved in Japan, 1996 and 1997 

Exhibit 7-2:    1998, Leading Pharmaceutical Wholesalers in Japan

Copyright 2000, Medtech Insight, LLC