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KMID : 0926620090140040052
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Korean Journal of Hospital Management
2009 Volume.14 No. 4 p.52 ~ p.70
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A Study for The Pharmaceutical Pricing Standard of the National Health Insurance in Japan
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Ryu Chung-Kul
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Abstract
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This study is to analyse the reimbursement prices of drugs in Japan. Japan has the world’s second-largest pharmaceutical market, and the world’s largest price-controlled pharmaceutical market. The reimbursement prices of new drugs in Japan are determined by confidential negotiations between the manufacturer and the Japanese Ministry of Health, Labor, and Welfare. Pharmaceuticals account for a larger share of total healthcare expenditures in Japan than in most other major pharmaceutical markets such as France, Germany, United Kingdom and United States. Prescription drugs’ share of total healthcare spending has slightly increased in recent years, from 20.2% in 2000 to 21.5% in 2004, the most recent year for which data are currently available. This trend is attributable to the effect of the Japanese rapidly aging population that stimulates demand for healthcare services. There are several method of price setting for drugs as below. First, on the initial pricing of branded drugs, is the similar-efficacy pricing method and cost calculation method. Second is postmarketing price changes which are biennial price revisions under the rule of National Health Insurance. Third is the rule of the generics price. Recently, the generics market is expanded because there are increasing numbers of hospitals by DPCs(Diagnosis-procedure Combinations).
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KEYWORD
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similar-efficacy pricing, cost calculation method, postmarketing price change
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