Understanding the psyche of Japanese pharmaceutical consumers is really a case of understanding the psyche of older and elderly Japanese.
Understanding the psyche of Japanese pharmaceutical consumers is really a case of understanding the psyche of older and elderly Japanese. An aging society with strong expectations for longevity has created a substantial segment of frequent pharmacy users, with growing concerns about their health, and their ability to attract the attention of government and industry to address them.
Japan is in the midst of a massive demographic bulge, where mature and elderly Japanese make up an increasingly larger proportion of the population. Currently, close to 20 percent of the population is aged over 65 (2004 Census data). The Japanese government expects that by 2014, the number will grow to one quarter. Driving this steady increase is Japanese longevity, the highest in the world, with a life expectancy of around 86 years for women and 79 for men.
Cost is generally not a concern for Japanese patients, with medical insurance fairly comprehensive and universal. Drug prices are controlled by the government and it is very rare for therapies to be refused on the basis of cost or for its affordability for patients. However, cost is and has been a factor driving changes such as the shift from ethical to generic medications.
All residents of Japan have health insurance cover through one of two compulsory programs. Covered through their employers, those in full-time employment (and their dependants) are required to pay a 30 percent co-payment for all medical treatment, while the unemployed, retired or self-employed, are covered by a National Heath Insurance program.
Relationship with the physician
Japanese physicians occupy a lofty social position in Japanese society, although patients do not always follow a physician’s recommendations or instructions. In fact, a major characteristic of the Japanese patient-physician relationship is one of consensus. A physician will recommend a course of treatment to his/her patient, but will adjust it to accommodate the patient’s wishes as much as reasonably possible. One area where this dynamic is most noticeable is in the treatment of allergies. Tokyo, in particular, is home to a large number of allergy sufferers. During the peak allergy season, patients seeking relief from allergy symptoms will often request medication based on past experience or word of mouth. Physicians are generally very receptive to these requests.
For Japanese patients, expectations of a consultation with a physician are high. Side effects are generally not tolerated, and there is a marked preference for safety over efficacy. While most patients prefer quick cures via strong medication, the mature or elderly patient in Japan would prefer a milder course of treatment even though it means recovery would be more gradual.
Health awareness vs Pharmaceutical brand awareness
Levels of health awareness are reasonably high in Japan. The main factors affecting these levels of awareness are: the popularity of health-oriented television shows (Aru Aru Daijiten, Omokirri Terebi), high Internet penetration and plenty of health-oriented web sites, and the prevalence of patient organizations with various awareness-raising activities. Yet awareness of pharmaceutical brands is low, particularly towards the non-Japanese brands and makers. As in most countries, Direct To Consumer (DTC) advertising is prohibited in Japan, but as an alternative, disease awareness campaigns are widely used. Highly developed Japanese OTC brands or brands with large market share usually benefit from this type of advertising, while foreign brands have not been as successful. Strict prohibitions against DTC advertising make it more difficult to generate brand awareness.
The needs of Japanese pharmaceutical consumers for more and better therapies are on a collision course with efforts by the government to reduce healthcare costs. The future will likely involve some kind of cost containment. Current cost containment methods, such as control over drug pricing, increased usage of generics and regular drug price-cuts, may need to be accompanied by increased incentives to physicians to avoid over-treatment.