Tomoyuki Takura

By Tomoyuki Takura

Healthcare systems generally help improve clinical outcomes by increasing public financial investment. Reasonable policymaking is crucial for identifying the financial burden involved, and analytical tools related to the relationship between universal health coverage (UHC) and socio-economic factors are essential. This study, along with the context and reports related to health insurance systems, examines the financial mechanisms that support UHC and the economic factors that dominate the clinical outcomes that benefit from it. The first section examines the socio-economic factors that affect universal coverage. Examples of methods for quantitatively evaluating the relationships and their analysis results are also summarized. The subsequent section summarizes the concept of medical value and the methodology for its evaluation, which are indispensable for examining the appropriate development of medical insurance systems. Research cases related to the significance of lifesaving and drug discovery are introduced, considering the possibility of allocating public resources. In the final section, the concept of price formation, which also considers medical value, is organized from the perspective of economics and medicine, with the optimization of medical treatment behavior in mind. For example, a report that analyzes the factors of price levels, focusing on Japanese private practices, is introduced.

Part of the book: Health Insurance

By Tomoyuki Takura, Naotsugu Ichimaru and Atushi Aikawa

The medical treatment of renal failure is increasingly being discussed in terms of medical economics against the background of disease mechanisms, treatment techniques, and related systems. Particularly, renal replacement therapy requires considerable medical resources and results in high medical costs; therefore, the interest in medical economics is increasing worldwide. This article discusses the cost-effectiveness of renal replacement therapy using macro- and micro-analyses. Based on the macroscopic analysis of international comparisons of renal replacement therapy systems based on medical expenses per patient with end-stage renal disease and a one-year mortality rate, Japan performed better than other developed countries. A clinical economic study of renal replacement therapy is significant because it quantitatively demonstrates the socioeconomic value of life-saving and health benefits (Hemodialysis: approximately 6.5 million JPY/Qaly). In other words, even with high annual medical expenses and a heavy financial burden, the level of medical fees is appropriate from the perspective of the public’s value judgment. A micro-analysis comparing the cost-effectiveness of marginal and standard donors revealed no statistically significant difference in their cumulative medical costs per long-term life expectancy. Thus, evidence and decision-making related to medical economics are required for the sustainable development of the medical system for end-stage renal disease.

Part of the book: Updates on Renal Replacement Therapy