In recent years, reform of National Health Insurance System is one of the political issues in Japan. The key of this issue is how intergenerational equity is attained, adjusting the drastic transition in population structure. In order to argue this theme, it is necessary to have the information about “Lifetime Medical Expenditure”(henceforth, LME),

In this article, I had estimated LME by three methods, using medical claim data, which were of 2 groups of insurance system. One is the estimation using stationary population (Method 1), the second is that using survival rate and consultation rate (Method 2), the third is that adjusting “Pre-Death Medical Expenditure”(Method 3).

As a result, I obtained that LME was 14-15.8 millions yen by Method 1, and 16.9-18.7 millions yen by Method 2. The result that estimated by Method 3 revealed that Pre-Death Medical Expenditure much affected the estimation of LME. The result of Method 3 was that they needed 13.9 millions yen as LME, and it was the most real of 3 methods.

The impact of R&D labs' external and internal collaboration on their perception of their R&D performance is examined, with our data from the Japanese and non-Japanese pharmaceutical firms. Our focus is on the extent to which R&D labs' collaboration with universities and other local institutions，as well as that with other intra-firm labs, would contribute to their R&D performance. Our result indicates that the impact depends on different types of R&D performance. For example, the labs' performance in basic research is enhanced by their intensive research collaboration with the local universities, whereas the performance in clinical trial is positively affected by the labs' extensive knowledge exchange with other intra-firm labs. Such findings from the questionnaire analysis are triangulated and interpreted together with the qualitative data from our fieldwork.

The change of life-style and the advance of medical technology have made the average life span in Japan extend for the last some decades. At the same time, these have induced the life-style related diseases and worsen the life quality. The increase of the number of life-style related diseases patients is a serious problem itself and causes financial problem. One of the measures to solve the each problems is health activity implemented by Health Insurance Society. In this paper, we investigate how this activity affects the enrollees of Health Insurance Society. We show that this activity reduces medical care cost and makes enrollees better off significantly. But these effects do not seem large. For the sake of improvement of our life quality, we suggest that this activity should be implemented more efficiently.

Patients with dementia frequently show abnormal behaviors such as wandering, sleep disturbance, etc. These symptoms are recently referred to as behavioral and psychological symptoms of dementia (BPSD), which are a major burden for family and caregivers. Increasing medical expenses are one of the major economic problems in developed countries. Although various anti-psychotic drugs have been used for treatment of the BPSD, the clinical economic analysis of such drugs has not been fully performed. To evaluate the cost-benefit of anti-psychotic drugs in the treatment of BPSD for institutionalized patients with dementia, the daily sleep and wake patterns of sixty six patients with Alzheimer's disease (AD) in a geriatric institution were visually monitored on an hourly basis for 7 consecutive days. After randomly dividing the sixty six patients into two groups, a low dose of risperidone, an anti-psychotic drug, was administered for the thirty four patients, especially those manifesting wandering behavior. After a small dose of risperidone, that cost less than ＄0.50 per person per day, the mean wandering hours decreased by 2 hours per day. The decreased wandering of the patients alleviated the caregivers' burden, allowing them to devote more time to other work, a savings of at least ＄15.00 per caregiver per day. The appropriate use of anti-psychotic drugs in the treatment of wandering of AD patients can decrease the caregivers' working hours, worth at least ＄15.00 per caregiver per day in Japan.