医療改革提言 競争力高めて成長の原動力に

The Yomiuri Shimbun May 9, 2013
Enhance Japan's medical care competitiveness to boost growth
医療改革提言 競争力高めて成長の原動力に(5月8日付・読売社説)


Japan's medical care is in a precarious situation. It is winning in the technology field, but losing when it comes to business.

Although the nation has superb technologies, it lags when it comes to the practical use of drugs and medical equipment.

These concerns were behind The Yomiuri Shimbun's decision to propose reform plans that would make Japan's medical care more competitive internationally and boost the country's economic growth.

Fostering the medical care industry is one pillar of a growth strategy that the government will compile in June. We urge the government to map out concrete and effective policies.

The core of The Yomiuri Shimbun's five-point proposal is to strengthen medical care as an industry and harness it as an engine for economic growth.

Excess of imports hits 3 tril. yen

Japan's rapidly graying population has increased demand for medical and nursing care, and imports of drugs and medical equipment are growing. On the other hand, exports of drugs and medical equipment remain anemic, with imports exceeding exports by about 3 trillion yen in 2011. A colossal amount of Japan's wealth is being sucked overseas. Sitting idly by is not an option.

As exemplified by Kyoto University Prof. Shinya Yamanaka, who won the 2012 Nobel Prize in Physiology or Medicine for his research on induced pluripotent stem (iPS) cells, Japan is a world leader in the field of basic research. However, the country straggles in the application of technology and relies heavily on foreign products.

An episode involving a surgical robot named "da Vinci" epitomizes Japan's current situation.

Manufactured in the United States, the computer-controlled da Vinci moves more delicately than a doctor's hands and fingers. By operating the robot instead of directly holding a scalpel, the surgeon can perform more accurate surgery. The da Vinci surgical system is being used in hospitals around the world.

But as a matter of fact, a Japanese researcher studying artificial organs made a drawing that looked identical to the da Vinci robot in the 1970s. Unfortunately, the researcher's idea never came into practical use and was forgotten. The drawing was discovered among the researcher's possessions in 2011.

The reason such a valuable and outstanding idea did not get off the drawing board is because various obstacles clog the system for commercializing such devices. These obstacles must be cleared so Japan's medical care industry can grow.

Cooperation necessary

The Yomiuri Shimbun proposed excellent research results be used through collaboration between the medical and engineering fields. The government plays an important role in encouraging companies with technological expertise to enter the medical care market and in strengthening cooperation between business and academic circles.

The time and cost required for clinical trials to ensure the safety of drugs and medical equipment in Japan are far longer and greater than in foreign countries. This saps corporate enthusiasm for developing medical products.

For example, South Korea has huge hospitals with more than 2,000 beds, allowing each hospital to comfortably secure enough patients for its own clinical trials. Japan, on the other hand, has smaller hospitals, most of which are not equipped to carry out such trials.

A cluster of research institutions, hospitals and corporations have been set up in a special zone in Kobe designated by the government to develop advanced drugs and other medical products. However, current regulations restrict the number of beds at each hospital, so it is impossible to construct large hospitals there. It is imperative that the government quickly ease these regulations so a core hospital can be built to conduct clinical trials.

Safety screening of medical equipment does not require as much data as that of new drugs, which must be backed up by a huge volume of research figures. Despite this, the time required for a medical device to win government approval after being developed is about two years longer than in the United States.

We think it would be worthwhile to let a private institution, rather than regulatory authorities, screen and approve the use of new medical equipment, as is the case in Europe.

The government should expand the scope of tax cuts for investments geared to research and development in this field, paving the way for venture companies to enter the business.

Also, there must be an institution that directs Japan's medical technology development.

A good model for Japan is the U.S. National Institutes of Health (NIH), which orchestrates medical research and development in the United States. We welcome the government's move toward establishing a Japanese version of the NIH.

Above all else, Japanese medical researchers will need to change their perspectives for boosting the medical industry.

Japanese universities tend to give more weight to basic medical research. We believe, however, they should give higher appraisal to clinical research results, which are useful to actual treatment.

Expand mixed treatment

Under Japan's universal medical insurance system, anybody with a medical insurance card can receive treatment at any institution. The Yomiuri Shimbun's five-point proposal calls for maintaining this system so people can be assured that they can still get medical treatment.

But financial constraints will make it difficult to cover all new medical technology under the medical insurance system. It is necessary to expand the scope of so-called mixed treatment, in which medical tests and drugs are administered--and covered by public insurance--and advanced treatments, which are not covered by insurance, are provided.

At present, this mix is allowed for about 100 kinds of treatment designated by the Health, Labor and Welfare Ministry, such as a heavy ion radiotherapy, a form of high-precision radiation therapy.

The unregulated expansion of allowable mixed treatments must be avoided. But if the procedures involve such state-of-the-art treatment as regenerative medicines that have been confirmed safe, we think they should be approved.

Building a robust medical industry and maintaining the medical insurance system will certainly serve the best interests of patients.

(From The Yomiuri Shimbun, May 8, 2013)
(2013年5月8日01時21分 読売新聞)

by kiyoshimat | 2013-05-10 07:47 | 英字新聞

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