Japan’s Reimbursement Mechanism for Pharma Products — Stronger Than Before

  • Japan’s governing bodies and reimbursement mechanisms and policies
  • New health technology assessment (HTA) method — cost-effectiveness assessment
  • Parameters used for reimbursement pricing
  • The Japanese government’s mechanism(s) for controlling drug pricing
  • Recent examples of price cuts and price increases

Key Takeaways

  • Reimbursement pricing assessment takes 60 days or a maximum of 90 days from market authorisation to patient access.
  • Considers average of foreign reference pricing from the US, the UK, Germany and France as one of the benchmarks for setting reimbursement price
  • Provides price maintenance premiums to support innovation in drug discovery
  • Cost‐effectiveness assessment (CEA) is conducted only for highly innovative and financially impactful drugs
  • Implements CEA method to adjust prices post-launch, it happened for the first time in 2021
  • Shifted drug price revision from biennial to every year, where the NHI list price is corrected using actual purchase/market prices Some of the products price increased by +20% during 2020 price revisions (Faslodex and Dupixent)

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Acuity Knowledge Partners

Acuity Knowledge Partners

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We write about financial industry trends, the impact of regulatory changes and opinions on industry inflection points. https://www.acuitykp.com/