Abstract
In 2011, the maximum dose for methotrexate (MTX) was also increased in Japan, enabling more strategic treatment. Increased doses of MTX and its combined use with biological disease-modifying antirheumatic drugs (bDMARDs) may be expected to improve long-term prognosis even in patients with high disease activity, for whom treatment had heretofore been difficult. On the other hand, the use of high-dose MTX and bDMARDs has been associated with increased medical costs.
Under the fiscal year 2014 revisions to medical treatment fees, four major changes were made in regard to rheumatoid arthritis (RA) treatment as follows: revisions to the index at the time of medical certificate creation according to the Act on Welfare of Physically Disabled Persons, the guidance and management fees for self-injection at home of bDMARDs, and addition of health insurance points for rehabilitation, and an increase to the target rate of generic drugs. Physicians in charge of RA treatment should have a sufficient knowledge of social insurance systems as well as a detailed understanding of revision contents. Moreover, in order to maintain social security systems, it is essential for individual clinicians to minimize medical costs as much as possible and protect finite healthcare resources.
