The Journal The Authority on Global Business in Japan

Over several years, effective government policies and efforts by the Ministry of Health, Labour and Welfare (MHLW) and the Pharmaceuticals and Medical Devices Agency have resulted in significantly reducing the time necessary for reviews and approvals for new drugs and devices in Japan.

One of the biggest obstacles to patient access to new medical innovation, beyond regulatory hurdles is, however, the universally conservative nature of medical practice worldwide.

The adoption and widespread use of medical innovation is often slowed by existing rules, guidelines, standard practices, and social customs. This results in what might be termed a practice lag—the time lag between the introduction of medical innovations, practices, and procedures and their adoption and widespread use.

Though the practice lag is common to the medical field worldwide, when combined with conservative aspects of Japanese culture, lag times in Japan often tend to be greater than in other developed countries.

A principle goal of the American Chamber of Commerce in Japan’s (ACCJ’s) advocacy for the speedy adoption of evidence-based global best practices is to reduce the practice lag in Japan—by showing how medical innovations in drugs, devices, diagnostics, as well as in standard practices and procedures can yield enhanced patient outcomes, healthcare system improvements, and overall cost effectiveness.

The first Healthcare Policy White Paper: Improving Health and Productivity in Japan, was released as a companion document for the ACCJ Growth Strategy Task Force’s white paper in 2010. The 2010 white paper had 16 topic sections offering 53 recommendations based on the belief that improving the health of the Japanese people would not only result in a higher quality of life, but also in an increase in labor productivity and a boost in economic  competitiveness.

In 2011, the ACCJ Health Policy White Paper: Proposals to Reduce the Economic Burden of Disease by Promoting Prevention and Early Detection was greatly expanded to 27 topic sections offering 124 recommendations founded on evidence-based global best practices and showed as examples of policies likely to yield a significant and positive impact. That being said, to gauge the effectiveness of our recommendations, a review was conducted after the implementation of reforms on April 1, 2012.

In brief, roughly 37 percent of the 124 recommendations were fulfilled in part or in their entirety. The most significant progress was seen in continued government funding of national cancer screening initiatives and in the substantial increase in government funding to enhance infection prevention and control at hospitals in Japan.

In 2013, the ACCJ and the European Business Council in Japan (EBC), the trade policy arm of 16 European chambers of commerce, teamed up for the first time to issue the joint ACCJ–EBC Health Policy White Paper 2013: Lengthening Healthy Lifespans to Boost Economic Growth. With this collaboration, the white paper was expanded to 36 topic sections offering 179 recommendations.

As with previous white papers, the goal has been to shift medical practice in Japan from a purely disease treatment paradigm to a prevention paradigm that focuses on screening, early detection, and early treatment of disease—which promises to prevent disease, enhance quality of life and worker productivity, yield cost effective interventions, and produce better patient outcomes.

As was done in 2012, a review was conducted after the implementation of reforms on April 1, 2014. Once again, over 30 percent (31.2 percent) of the 179 recommendations were fulfilled in part or in their entirety.

Notable progress included an acceptance of functional claims for processed foods (which can have health benefits beyond simple prevention of deficiency in certain nutrients), a commitment to new health IT policies, continued government funding of national cancer screening, and a first-ever MHLW mandate requiring a substantial increase in infection reporting at larger hospitals in Japan.

Building on our collaboration, the ACCJ and EBC have worked closely to update and further expand the scope of the ACCJ–EBC Health Policy White Paper for 2015—which has 41 topic sections offering 198 recommendations.

To learn more, please visit the ACCJ online at


William Bishop, Chair of ACCJ Healthcare Committee