This study investigates how demand for 39 best-selling cardiovascular pharmaceuticals wes determined. The government regulates the “official prices” of pharmaceuticals used in the nation-wide health insurance system, while it does not regulate the “wholesale prices” used in transactions between wholesalers and hospitals/pharmacies. The differences between the two prices are realized as the income of hospitals/pharmacies. By extending the method of Anegawa (1999a), I estimate the effects of the official prices, wholesale prices, and individual-specific effects on the change of demand. The old pharmaceuticals with generic competition have insignificant official price elasticity while they have significant wholesale price elasticity around -1.3. Suppliers could increase the demand and sales of these products by lowering the wholesale prices. The new pharmaceuticals without generic competition have significant official price elasticity about 2.0and wholesale price elasticity around -1.0. In this case, suppliers could not increase sales by lowering the wholesale prices. I found that the individualspecific effects have increased significantly in the late 1990s and their magnitude has exceeded the effects of the prices. A reform of pharmaceutical price regulations should distinguish the differences between pharmaceuticals with and without generic competitions. A proposal to set the single official price both for original and generic products will not promote sales of generic products. Price regulations have become less important as a means to control the demand for pharmaceuticals, while they are still effective as a means to constrain their sale.

View full abstract

This paper attempts to replicate QOL from subjective health evaluation in Japan following Cutler and Richardson (1997) and Groot (2000) and then extend the model in several ways. Firstly, while previous studies defined the domain of QOL in an ad hoc manner, i. e. excluding “excellent” or “very poor” respondents, this paper suggests more rigorous alternative measures. Secondly, heterogeneity among individuals, which is inevitable in micro-data, is accounted for in the estimation. Thirdly, this paper compares QOL over a period of six years.
The estimation results show the following: Although almost all symptoms and diseases worsen health evaluation, some symptoms and diseases raise subjective health. There is no such counterintuitive case in UK or US studies. The QOL impact of symptoms and diseases is stable over six years, and aggregate QOL is very stable in this period.

View full abstract

The new GCP rule created an impact on clinical trials in Japan. Medical institutes conducting clinical trials claim management costs to pharmaceutical companies under formal guidelines. The present study evaluated the actual expenses and claimed costs in a clinical trial carried out under the new GCP rule in 1999 at Tokyo Women's Medical University Hospital. The model clinical trial was of a large scale (45 cases) and was carried out with research coordinators (CRC). The claim was based on the formal guidelines and the institutional guidelines for the CRC cost. The claimed costs exceeded the actual expenses when evaluated for the model. However, when hypothetical calculation was performed on the model of a downscaled trial (5 cases, a typical scale for clinical trials in Japan), the calculated actual expenses exceeded the costs to be claimed by the guidelines. The results indicate that further consideration for the cost of clinical trials may be an economical factor in facilitating clinical trials in Japan.

View full abstract

To examine the situation of interactive health communication (IHC) using information technology (IT) in Japan, a questionnaire survey of general practitioners (N=126) and analysis of the contents of websites of medical clinics (N=177)were conducted. Most of the respondents to the survey used the internet and e-mail, and 26 had established a website for their clinic. Many respondents answered that clinic websites should include information about available examinations and the details of practitioners, in addition to general information. “Helping patients select institutes and practitioners” and “cooperation between medical institutes” were considered to be the merits of clinic homepages. “Dissemination of inappropriate information”, “usage for advertisement of healthrelated goods”, “troubles related to the Internet” and “manpower and time required for management” were considered to be the demerits. Among the kinds of clinics that had a website, cosmetic surgery was the most common, followed by internal medicine, dermatology, and obstetrics and gynecology. In addition to general information such as address and department, various health-related information, including consulting and reservation using e-mail wer e included in the contents of websites. IT has great potential to be widely applied in the health and medical field for the dissemination of information and interactive communication. To promote a wider and more appropriate spread of IHC, scientific assessment and evaluation of the effects is needed.

View full abstract

Recently, many of medical institutions are faced with intense competition to survive, and have to reform considerably. In business, there is the tendency for companies to build cooperative relations with surrounding companies. Similarly, in the health care industry, there is the tendency for hospitals to build cooperative relations with surrounding hospitals, clinics, and welfare organizations. Today, relationships between medical institutions are more important, because of functional specializations and efficient utilization of medical resources.
In this paper, we have studied the regional medical network of Kameda General Hospital, and analyzed the elements of its success. The outcome of the study has revealed the following three points.1) Strategic alliances with regional medical institutions through information sharing,2) Good relationships with regional medical institutions that are customers,3) Patient-oriented nature.
This hospital doesn't have “enterprise” strategies but rather “organization”ones. The purpose is to gain more profit and benefit by utilization of human resources, material resources and the information that all members have.

View full abstract

An analysis of the contents of the websites of hospitals located in Tokyo, Kanagawa and Chiba prefectures, showed the pattern that the information was focused on mainly increasing accessibility, such as with respect to the characteristics of the hospital. Medical information and information on patients' education were limited to 10 to 20% of the total. Sites providing hospital-patient two-way communication were rare.
Since the need f o r information will increase, hospital websites will become important for building relationships between hospitals and patients. Not only the number of websites, but also the contents should be expanded.

View full abstract