Yasunaga Hideo, Ide Hiroo, Imamura Tomoaki, Ohe Kazuhiko
Department of Planning, Information and Management, University of Tokyo Hospital, Tokyo, Japan.
Circ J. 2007 Jul;71(7):1128-30. doi: 10.1253/circj.71.1128.
The price disparity between Japan and foreign countries for medical devices is a controversial issue. Price differences existed between Japan and USA for various medical devices in early 2005, so in the present study, a more precise and detailed investigation of the latest market prices of medical devices between Japan and USA was conducted in 2006, focusing on coronary stents and percutaneous transluminal coronary angioplasty (PTCA) catheters, for an evaluation of the efficacy of current Japanese policies.
Japanese market prices were obtained from 31 university hospitals, and US market prices were obtained from 1 hospital chain and 2 group-purchasing organizations. The price ratio (Japanese market price/US market price) was determined to be 1.2-1.4 for drug-eluting stents (DES), 1.6-2.4 for non-DES, and 4.1-5.1 for PTCA catheters.
Results showed that the price disparity was relatively small for DES, but still significant for non-DES and PTCA catheters. Radical measures must be taken to improve the fundamental causes of price disparity and might include reviewing the implementation of the Japanese Pharmaceutical Affairs Law, abolishing the reimbursement price system for medical devices, and establishing centers of clinical excellence.
日本与外国医疗器械价格差异是一个有争议的问题。2005年初，日本和美国各种医疗器械存在价格差异，因此在本研究中，2006年对日本和美国医疗器械的最新市场价格进行了更精确、详细的调查，重点是冠状动脉支架和经皮冠状动脉腔内血管成形术（PTCA）导管，以评估日本现行政策的效果。
从31家大学医院获取日本市场价格，从1家连锁医院和2家团购组织获取美国市场价格。药物洗脱支架（DES）的价格比（日本市场价格/美国市场价格）确定为1.2 - 1.4，非DES为1.6 - 2.4，PTCA导管为4.1 - 5.1。
结果表明，DES的价格差异相对较小，但非DES和PTCA导管的价格差异仍然很大。必须采取激进措施来改善价格差异的根本原因，可能包括审查日本《药事法》的实施情况、废除医疗器械报销价格制度以及建立卓越临床中心。
