The creation of efficient and effective healthcare systems to ensure innovation and sustainability is an issue facing not only in Japan but every country worldwide. Efforts are being made country by country to appropriately assess medical treatments. Some people expect that cost-effective healthcare and the optimal allocation of resources may become possible via Health Technology Assessment (HTA). In Japan, there have been discussions held on the introduction of HTA since FY2012, particularly at the Committee for Cost-Effectiveness Assessment within the Central Social Insurance Medical Council (Chuikyo). A trial introduction of Cost-Effectiveness Assessment was conducted in FY2017 and dialogue towards its full-scale introduction continued in FY2018. A highly revolutionary, highly economically effective drug and medical devices cost effectiveness analysis method saw full-scale introduction in April 2019.

Since FY2016, HGPI has continuously held a series of expert meetings and opinion exchange sessions on these themes entitled the “Rebalancing Healthcare Systems: Innovation and Sustainability Series.” In FY2018, we contributed to deepening discussion in this field of policy together with multi-stakeholders through four roundtable discussions and two symposium-style expert meetings.

Based on the discussions held in FY2018, we have identified perspectives and items that must be examined in future discussions to build a healthcare system that balances sustainability and innovation. These observations have been included in the activity report.

For the full report, click the PDF linked below.

* The meetings held in FY2018 are as follows.
Preparatory Meeting “Rebalancing Healthcare Systems: Innovation and Sustainability Series – Issues Identified from the Trial Introduction of Cost-Effectiveness Assessment” (May 31, 2018)
First Forum: “Technical Issues-Analysis and Appraisal Issues Identified through the Trial Introduction of Cost-Effectiveness Assessment” (July 19, 2018)
Second Forum: The Introduction of Cost-Effectiveness Assessment, Its Impact, and Compatibility with Other Systems (September 13, 2018)
Third Forum: Public Understanding – Increasing Public Awareness and Understanding on the Impacts and Benefits of Cost-Effectiveness Assessment – (November 12, 2018)
Global Expert Meeting: “The Future of Health Technology Assessment” (September 12, 2018)
Expert Meeting “The Future of Healthcare in Japan and Cost-Effectiveness Assessment” (December 14, 2018)

Participants
In the six meetings held in this series in FY2018, many experts honored us with their participation. We express our utmost gratitude to everyone who contributed their opinions and expertise to the discussions.

Please note: the meetings detailed in this report were held in accordance with the Chatham House Rule, which allows for public reporting of the content of discussions, but prohibits reporting on who made which statements specifically. While this report was created based on the main issues and ideas raised in our FY2018 meetings, the statements and opinions expressed do not necessarily represent the opinions of any one participant.

Participants: (titles omitted, in alphabetical order by last name)
Manabu Akazawa (Professor, Department of Public Health and Epidemiology, Meiji Pharmaceutical University)
Shinsuke Amano (Executive Director, Japan Federation of Cancer Patient Groups)
Michael Drummond (Professor, Centre for Health Economics, University of York)
Takashi Fukuda (Director, Department of Health and Welfare Service, National Institution of Public health)
Yasushi Goto (Department of Respiratory Medicine, National Cancer Center Hospital)
Chris Hourigan (Vice Chair, Pharmaceutical Research and Manufacturers of America (PhRMA))
Mamoru Ichikawa (Principal Program Director, Production Center I Science Programs Division, Program Production Department, Japan Broadcasting Corporation (NHK))
Ataru Igarashi (Associate Professor, Graduate School of Pharmaceutical Sciences, The University of Tokyo)
Shunya Ikeda (Professor, Graduate School of Medicine/Public Health, International University of Health and Welfare)
Satoshi Imamura (Vice President, Japan Medical Association)
Ichiro Innami (Professor, Faculty of Policy Management, Graduate School of Media and Governance, Keio University)
Sachie Inoue (Director, Crecon Medical Assessment Inc.)
Isao Kamae (Project Professor, Graduate School of Public Policy, the University of Tokyo)
Kosuke Kato (Managing Director, Edwards Lifesciences Limited)
Shigekazu Komoto (Counselor for Policy Planning, Coordination, Health Insurance Bureau, Ministry of Health, Labour and Welfare(MHLW))
Keiji Kono (Senior Vice President, Global Health Policy, External Affairs, Chugai Pharmaceutical Co., Ltd.)
Hidehito Kotani (President, PHC Holdings Corporation)
Hideo Kunitoh (Division of Chemotherapy, Department of Internal Medicine, Japanese Red Cross Medical Center)
Yoshiyuki Majima (President, Pancreatic Cancer Action Network Japan)
Hiromi Mitsubayashi (Member of the House of Representatives)
Toshio Nagase (Director, Government Affairs, Gilead Science K.K.)
Hiroshi Nakamura (Professor, Graduate School of Business Administration, Keio University)
Koichi Nakao (President and Chief Executive Officer, Saiseikai Kumamoto Hospital)
Ryu Niki (Adviser and Professor Emeritus, Nihon Fukushi University)
Yoshie Onishi (Director, Japan Operations, Creativ Ceutical K.K.)
Shinya Saito (Professor, Graduate School of Health Sciences, Okayama University)
Naokazu Saito (Chief, Policy Intelligence Division, Integrated Market Access Department, Janssen Pharmaceutical K.K.)
Hiroyuki Sakamaki (Professor, School of Management, Tokyo University of Science)
Naomi Sakurai (President, Cancer Solutions Co., Ltd.)
Yasushi Sakuramoto (Assistant Director, Medical Economics Division, Health Insurance Bureau, Ministry of Health, Labour and Welfare (MHLW))
Kojiro Shimozuma (Professor, Department of Biomedical Sciences, Graduate School of Life Sciences, Ritsumeikan University)
Keizo Takemi (Member of the House of Councillors)
Tomoyuki Takura (Project Professor, Department of Healthcare Economics and Health Policy, Graduate School of Medicine and Faculty of Medicine, the University of Tokyo)
Makoto Tamura (Founder and CEO, Healthcare System Planning Institute / Research Professor, Graduate school of International University of Health and Welfare)
Rosanna Tarricone (Associate Dean, Government Health and Non Profit Division, SDA Bocconi School of Management / Associate Professor, Department of Social and Political Science, Bocconi University)

For information concerning meetings in this series from before FY2018, please see the following.
Urgent Forum on Drug Pricing Reform (December 13, 2016)
“Rebalancing Health System: Innovation and Sustainability” A Joint Global Expert Meeting convened by the CSIS and HGPI (April 14, 2017)
The 2nd Global Expert Meeting of The “Rebalancing National Health Systems: Innovation and Sustainability” Series—The Current Status, Challenges, and Opportunities of Health Technology Assessment (HTA) in Japan (October 5, 2017)