In Japan, cancer screening is provided as a public service for the most part. Although most of these programs are effective, the participation rate has reached a plateau and new participants seem to be rare. In this article, we analyzed factors influencing participation of cancer screening using an original questionnaire survey. In the whole sample, age, income, current outpatient consultation, education and health insurance are related to participation.
The Analysis using the whole sample includes both supply side and demand side factors. To concentrate on analyzing the demand side factors and cancer screening provided as a pure public service, we limited the samples to those involved in national insurance. As a result, residents of towns and villages have higher participation and invitation cards by mail realize increased participation rate, but public announcements using papers, posters, and circulating notices have no effect.

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This study was attempted to identify function and roles of direct-to-consumer (DTC) advertising of prescription drugs in Japan. DTC ads are still in their infancy in Japan; however, their effectiveness has been widely discussed elsewhere. In this study, DTC advertising's impact on pharmaceutical companies, patients, and physicians were examined. The patient-physician relationship in Japan was given particular attention. The results of a questionnaire survey of 192 patients and an interview survey of 4 physicians are reported. Finally, implications for pharmaceutical company are discussed.

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In this paper, we comprehensively consider health insurance in Japan through analyzing "Japanese mixed treatment" which permits a mixture of free treatment with publicly insured treatment, from the viewpoint of efficiency and fairness. While socioeconomic environments have varied in Japan, it has been pointed out that the prohibition rule for mixed treatment is harmful. At this current stage of introducing mixed treatment, the health security system in Japan is required to have viewpoints about patients' needs and efficient allocation of health resources. Fairness must be secured to be consistent with these viewpoints. So, we examine the efficiency and fairness of the prohibition rule for mixed treatment through surplus analysis. Then we find that this rule has problems with not only efficiency but fairness. Next, looking more deeply at the concept of fairness, we take up Ronald Dworkin's theory of justice as a new notion of fairness, while giving consideration to the viewpoints stated above. In the process of reconsidering present conditions in line with Dworkin's theory, we can get many useful suggestions for the healthcare system in Japan in addition to mixed treatment, for example, the whole limiting concept of the coverage of public health insurance and the separation of roles between public sector and private sector.
In conclusion, we propose the following new healthcare system by introducing mixed insurance. It is vital that we change the conventional policy which covers all medical demands by only public health insurance and permit mixed treatment more flexibly for needs that public health insurance can't cover, having a clear distinction between the role of public sector and private sector. Then, each individual could cover for the cost by himself through private health insurance.

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This study developed a real option model for valuating clinical development projects being conducted by pharmaceutical companies. The model was especially applied to sequential clinical development projects with technical risk for project failure due to lack of safety/efficacy of a new drug.
Since a pharmaceutical clinical development projects face risk of external events such as competitors' entry to the market and official price reduction by the government, the model considers the impact of such external event on the project value.
The following results were found. First, the impact of external events in terms of probability of event occurrence and/or degree of downside jump on the value of the new drug enlarges critical value for project investment.
This suggests that the company should delay investment in the project until the value of the new drug becomes large enough. Second, when the probability of projict failure is large, the value of the investment option becomes small. Lastly, the model provides methodology for valuing for sequential clinical projects and critical value for theoptimal investment.

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