S-IV-5 小児医療保険制度の問題点 : 主として薬剤の適応の面から(シンポジウム IV 小児医療保険・公費助成制度の問題点, 第 34 回日本小児外科学会総会)

抄録

Resently, such cases for which doctor's fee are not paied by Japanese Medical Insurance have been increasing even if they were treated by established therapeutic methods which are well-known in the world, when those methods did not agree with the standards defined by the Japanese Ministry of Health and Welfar. Since the apllicable ranges of drugs for pediatric diseases are very narrow in general, it is often required to get special permission to use those drugs. Therefore, I am afraid that the improvement of therapeutic effects in pediatric field might become difficult because of such restriction in the insurance system. For example, Cyclophosphamide, which has been used to pediatric malignant neoplasmas for long time, is applicable for neuroblastoma and nephro-blastoma but not for the cases of malignant teratoid tumor and rhabdomyosarcoma, whereas both applications of Adriamysin to neuroblastoma and nephrobalastoma have not yet been approved. Also, Cis-platinum is not applicable for hepatoblastoma in the insurance system. In order to break out these present situations, I strongly wish that the Japanese Society of Pediatric Surgeons and the related societies would make much more efforts to implove Japanese Health Insurance System.