Ide Hiroo, Yasunaga Hideo, Imamura Tomoaki, Ohe Kazuhiko
The University of Tokyo Hospital, Department of Planning, Information, and Management, Hongo 7-3-1, Tokyo, Japan.
Health Policy. 2007 Jun;82(1):71-7. doi: 10.1016/j.healthpol.2006.08.003. Epub 2006 Oct 6.
Previous reports (1996, 1997) have revealed that the market prices of medical materials in Japan were two to four times higher than those in the US. The Japanese government introduced the foreign price adjustment rule (FPA) in 2002 to reduce reimbursement prices in Japan. We aimed to investigate the current price differences between Japan and the US in the first half of 2005 and to evaluate the effectiveness of the FPA.
The investigation was performed at two joint purchasing organizations (JPO) and a hospital group in the US, and at a university hospital in Japan. Forty-one items in 14 categories were selected in advance.
The price ratio (Japanese price/US price) was largest at 4.5-6.8 for percutaneous transluminal coronary angioplasty (PTCA) balloon catheters and 1.4-6.0 for vascular grafts. The price ratio was smallest at 1.2-2.4 for automatic sutures, 1.4-1.6 for Swan-Ganz catheters, and 1.5-2.3 for mechanical valves.
The price differences between Japan and the United States were found to have rather widened with the exception of the pacemaker, because their market prices decreased more markedly in the United States. The investigation suggests several problems with the FPA: (1) the determination process of reimbursement prices is inappropriate, which has made the Japanese market less competitive, (2) the FPA needs too much time for the resolution of price differences, and (3) price data collected according to the FPA lacks strictness.
The high prices of medical material in Japan need to be adjusted down with more appropriate measures such as the full cost or cost inclusion methods.
先前的报告（1996年、1997年）显示，日本医疗材料的市场价格是美国的两到四倍。日本政府于2002年引入了国外价格调整规则（FPA），以降低日本的报销价格。我们旨在调查2005年上半年日本和美国之间当前的价格差异，并评估FPA的有效性。
在美国的两个联合采购组织（JPO）和一个医院集团以及日本的一所大学医院进行了调查。预先选择了14个类别中的41种物品。
经皮腔内冠状动脉成形术（PTCA）球囊导管的价格比（日本价格/美国价格）最高，为4.5 - 6.8，血管移植物的价格比为1.4 - 6.0。自动缝合线的价格比最低，为1.2 - 2.4，Swan - Ganz导管为1.4 - 1.6，机械瓣膜为1.5 - 2.3。
除了起搏器外，日本和美国之间的价格差异被发现有所扩大，因为美国的市场价格下降更为明显。该调查表明FPA存在几个问题：（1）报销价格的确定过程不合适，这使得日本市场缺乏竞争力，（2）FPA解决价格差异所需时间过长，（3）根据FPA收集的价格数据缺乏严格性。
日本医疗材料的高价格需要通过更合适的措施，如完全成本或成本包含方法来下调。
