2018 Healthcare revision in Japan

In March 5th, the details of the 2018 healthcare revision was published (official documents are available only in Japanese).
www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000196352.html

Japan has biannual healthcare revision with re-pricing on all pharmaceutical products and devices. 2018 revision is effective from April 1st in 2018. The biggest three changes that I think in the 2018 revision are made on 1) bed categories, 2) drug/device pricing system including annual re-pricing and 3) Trial introduction of Cost-Effectiveness analysis. 

1. bed categories
Japan has more beds per capita compared than any OECD countries have and we need the resource shift from secondary medical services to the primary services. The new system encourages to increase nursing homes and to reduce acute beds, which are not quite limited to 'acute' phase use as the average length of stay was reported at 17 days compared to one digit in other countries in OECD report.

2. Drug/device pricing system
With an increasing pressure of medical expense on the national budget, annual re-pricing and x4/year re-pricing for certain products are introduced. Industries have been strongly against the annual re-pricing (practical price reduction) for several years, because an annual re-pricing which requires a broad survey in prices may increases the total national spending.

3. Cost-effectiveness analysis (CEA)
CEA introduction in the pricing/re-pricing process is still in a trial phase, yet prices of two products will be reduced and one product to be increased in April 2018, according to the result of the trial CEAs.