Abstract
Recently, the rheumatoid arthritis (RA) patient treated with biologic agents is increasing in Japan. Effectiveness of biologic therapy is remarkably excellent as compared with the existing RA treatment. However, biologic therapy has some problems, representative problems are serious adverse reactions and expensive medical fee. Expensive medical fee is the problem of both a patient and a clinic owner. As compared with the advanced nations, the prices of Japanese biological drugs except remicade are inexpensive, but copayment is expensive in Japan. Sincemedical fee is mostly covered by the medical insurance, a copayment is almost gratuitous or low price in advanced nations. On the other hand, there is compulsory insurance system in Japan and all the people is subscriber of medical insurance. However, the majority of insured patients have to pay 30% of medical fee as a copayment. Therefore, some Japanese patients cannot be treated with biologic agents, since expensive medical fee cannot be defraied. Although a biologic therapy requires extra costs, such as an exclusive drip infusion room and personnel expenses, only insufficient medical treatment fee is given to a clinic owner. The medical care system of the RA biologic therapy in outpatient clinic is still insufficient in Japan.
