The Journal The Authority on Global Business in Japan


There is no doubt that, in recent years, government policies have reduced the time necessary for review and approval of new drugs and devices in Japan. Beyond regulatory hurdles, however, one of the biggest obstacles between patients and access to new medical innovation is the slow pace of change to existing rules, guidelines, and standard practices. This results in what might be termed “practice lag”—the time between the introduction of new medical innovations and their adoption and widespread use.

At the American Chamber of Commerce in Japan (ACCJ), a principal goal of our advocacy for the speedy adoption of evidence-based global best practices has been to reduce the practice lag in Japan. We do this by showing how new medical innovations in drugs, devices, diagnostics, and standard practices and procedures can yield enhanced patient outcomes, improvements to the healthcare system, and increased overall cost effectiveness.

We believe that, by closing the practice lag, we can encourage a paradigm shift from purely disease treatment to screening, prevention, and early detection and treatment. This holds the highest promise of not only enhancing worker productivity and quality of life by preventing disease, but in yielding cost-effective interventions and better patient outcomes.


To encourage these changes, we have published five health policy white papers over the past six years. The first was issued in 2010 and featured 53 recommendations.

In 2011, the ACCJ Health Policy white paper expanded this to 124 recommendations. To measure effectiveness, a review was conducted after the implementation of reforms in 2012. To our surprise, roughly 37 percent of the 124 recommendations had been fulfilled in part or in whole.

Building on this success, the ACCJ and the European Business Council (EBC) teamed up to publish the ACCJ–EBC Health Policy White Paper 2013, which featured 179 recommendations. Our post-2014 reforms survey found that over 31.2 percent of the 179 recommendations had been fulfilled in part or in whole.

In 2015, the expanded ACCJ–EBC Health Policy white paper featured 204 recommendations. Beyond all expectations, the post-2016 reforms survey found that a whopping 42 percent of the 204 recommendations had been fulfilled in part or in whole—an all-time record.

Then, in February 2016, in response to Prime Minister Shinzo Abe’s call for increased women’s participation in the workforce, the ACCJ and EBC published the women’s health policy primer Healthier Women, Healthier Economy: Building a Stronger Economy by Empowering Women through Better Health, which features practical recommendations for both government and businesses. We look forward to measuring the success of this effort after the April 2018 healthcare reform.

I am proud of the policy and advocacy work the healthcare committee has pursued over the past several decades. Since 2010, the white paper initiative has provided us with a concrete way to measure our progress—at least on some policy fronts. With white paper recommendations, come post reforms, either a recommendation has been adopted or it has not. Nothing could be clearer.

Though this old cowboy will hang up his spurs at the end of the year—I will officially retire from BD Japan and as chair of the ACCJ Healthcare Committee on December 31—I am confident this important advocacy work will continue.

I would like to take this opportunity to thank everyone for their support over the years and to wish you all Happy Trails.

William R. Bishop. Jr. is chair of the ACCJ Healthcare Committee.