Report: Japanese Orthopedic Market Uniquely Influenced by Cultural Factors

Decision Resources Group (DRG) has found that the Japanese orthopedic device market is uniquely influenced by cultural preferences that make the market distinct from other major markets, such as in the United States. 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 until it is absolutely necessary, such as in the case of a hip fracture. Spinal procedures are also rarely performed using the highly invasive anterior approach. These factors will somewhat limit the volume of invasive orthopedic procedures performed in Japan through 2022. However, rising demand for orthopedic procedures in line with the aging population and increasing clinical data will result in gradual market expansion through 2022.

Other key findings from DRG’s Medtech 360 report entitled “Japanese Markets for Orthopedic Devices 2014” are as follows. Certain cultural practices, such as sitting on the floor to eat, are positive influencers on orthopedic device treatments. Although patients will defer knee replacements for as long as possible, when they do opt for these 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 technologies and have been comparatively slow to adopt the newer minimally invasive technologies, such as unicondylar knee implants or intramedullary nails. However, interest in these technologies has been gradually picking up.

Although vehicle accidents have historically been a driver of demand for trauma devices, initiatives implemented by the government to improve road safety will somewhat diminish the impact of this factor going forward.

“The Japanese regulatory system has potential to change in the long term because it is currently in a reshaping phase,” said Rene Azeez, an analyst from Burlington, Mass.-based DRG. “It is unlikely to change by 2022, however, and companies will continue to have to deal with an extremely cumbersome approval process. This is evidenced by the fact that no new spinal nonfusion technologies are anticipated to enter this market by 2022, despite significant product development activity in other countries. Additionally, biennial reimbursement cuts 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. 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. For example, NuVasive recently set up an office in Japan.”