Information Barriers to the Implementation of Economic Evaluations in Japan
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Pharmacoeconomics 2002; 20 Suppl. 2: 9-15 1170-7690/02/0002-0009/$25.00/0 © Adis International Limited. All rights reserved.
Information Barriers to the Implementation of Economic Evaluations in Japan Shuzo Nishimura,1 George W. Torrance,2 Naoki Ikegami,3 Shunichi Fukuhara,4 Michael Drummond5 and François Schubert6 1 Faculty of Economics, Kyoto University, Kyoto, Japan 2 McMaster University, Hamilton; Innovus Research Inc., Burlington; and Health Utilities Inc., Dundas; Ontario, Canada 3 Department of Health Policy & Management, School of Medicine, Keio University, Tokyo, Japan 4 Department of Epidemiology & Health Care Research, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan 5 Centre for Health Economics, University of York, Heslington, York; and Innovus Research UK, Amersham, Buckinghamshire; United Kingdom 6 Procrea Biosciences Inc., Royalmount, Montreal, Quebec, Canada
Abstract
With increasing cost-containment pressures within healthcare systems worldwide, economic evaluations of medical technologies, particularly pharmaceuticals, are used to aid the allocation of expenditure and resources. Facing similar pressures, Japan will probably also introduce economic evaluation of health technology. However, the structure of the healthcare system in Japan does not lend itself naturally to the collection of the epidemiological and cost data required for economic evaluations in medicine. In addition, there are no formal methodological guidelines in place for these analyses. To overcome these information barriers in Japan, progress may be aided by the adoption of approaches used in other countries for data collection and guideline development.
Economic evaluations compare the costs and consequences of alternative healthcare technologies in a particular patient population.[1,2] Consequences include not only efficacy and safety, but also the value of a product in terms of improved health outcomes, such as prevention of disease or better patient quality of life. All these factors are considered in relation to product costs, and the potential impact on healthcare budgets. Preparing for economic evaluations is therefore a complex process, requiring the collection of epidemiological data, clinical trial results, and information on pa-
tient health outcomes, healthcare resource use and expenditure. In many countries, the process is assisted by methodological guidelines for economic evaluations in healthcare.[3-5] If health economic evaluations were to be introduced in Japan, the kinds of data listed above would need to be available. However, there are a number of barriers to the collection of this information in Japan. Section 1 of this paper focuses on the absence of standardised epidemiological data, and the limited availability of information on healthcare costs. Section 2 examines the experi-
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ences of countries that have developed procedures for the systematic collection of data for economic evaluations, and discusses how some of the information barriers in Japan ma
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