Japanese Orthopedic Device Sector Influenced by Cultural Factors

These are the findings of Decision Resources Group (DRG; Burlington, MA, USA), which provides information and insights on critical issues within the healthcare industry.

For example, Japanese patients have a cultural aversion to surgery because it is seen as too invasive. As a result, most patients will defer large-joint surgery, such as knee replacements for as long as possible or until it is absolutely necessary, such as in the case of a hip fracture. But since certain practices, such as sitting on the floor to eat, are important culturally, when Japanese patients do opt for surgical procedures they will often choose more expensive options such as mobile-bearing knee implants, which offer greater flexion.

Japanese doctors are also generally reluctant adopters of new minimally invasive surgery (MIS) technologies such as unicondylar knee implants or intramedullary nails. Spinal procedures are also rarely performed using the highly invasive anterior approach. These factors somewhat limit the volume of invasive orthopedic procedures performed in Japan, and will continue to do so through 2022. However, rising demand for orthopedic procedures that fall in line with an aging population and increasing clinical data will result in gradual market expansion as interest in these technologies gradually picks up.

An additional hurdle is that the Japanese regulatory system is currently in a reshaping phase, which is also unlikely to change soon, and companies will continue to have to deal with an extremely cumbersome approval process. This is shown by the fact that no new spinal non-fusion technologies are anticipated to enter this market by 2022, despite significant product development activity in other countries. Additionally, biennial reimbursement cuts set by the Japanese Ministry of Health, Labor & Welfare (MHLW) will continue to limit the orthopedic device market.

“Local manufacturers have an advantage in Japan because they are better able to navigate local laws and customs,” said DRG analyst Rene Azeez. “As a result, many multinational competitors are working with Japanese distributors and are setting up local offices to establish networks with facilities and physicians in the area.”

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