Hostname: page-component-848d4c4894-jbqgn Total loading time: 0 Render date: 2024-06-22T13:28:36.233Z Has data issue: false hasContentIssue false

The Paradox of Decreasing Prices and Increasing Costs for Diagnostic Tests, Imaging, and Drugs in Japan

Published online by Cambridge University Press:  10 March 2009

Naoki Ikegami
Keio University
Shunya Ikeda
Keio University


Analysis of the 1987–1991 national outpatient claims data shows that the percentage of patients undergoing sophisticated diagnostic tests tended to increase and was greater if the hospital was larger, in the public sector, or affiliated with an university. For imaging, the percentage that had CAT scans performed increased, while the percentage undergoing x-rays using contrast medium and other tomography decreased. However, for drugs, newer and more expensive ones tended to be preferred irrespective of the providers' characteristics. Although costs arising from the shift to more expensive and sophisticated technologies have been largely contained by reducing their prices in the fee schedule, this cost-containment strategy faces structural problems. We advocate the establishment of an infrastructure that offers incentives for providers to conduct technology assessment and to use the results.

General Essays
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)



1.Ikegami, N., & Campbell, J. C.Medical care in Japan. The New England Journal of Medicine, 1995, 333, 1295–99.CrossRefGoogle ScholarPubMed
2.Ikegami, N., Fries, B. E., Takagi, Y., et al. Applying RUG-III in Japanese long-term care facilities. The Gerontologist, 1994, 34, 628–39.CrossRefGoogle ScholarPubMed
3.Ministry of Health and Welfare. Survey an social medicine according to clinical procedure (in Japanese). Tokyo:Kosei-Tokei-Kyokai, 19881992.Google Scholar
4.Ministry of Health and Welfare. Survey of medical institutions (in Japanese). Tokyo: Kosei-Tokei-Kyokai, 19901993.Google Scholar
5.OECD. OECD health data 95. Paris: OECD 1995.Google Scholar
6.Shakai Hoken Jumpo (in Japanese), 1989, 1641, 34.Google Scholar
7.Shakai Hoken Jumpo (in Japanese), 1996, 1905, 25.Google Scholar