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Hi Blog. In our previous blog entry, Debito.org Reader StrepThroat brought up the issue of Japanese medical prescription doses being too low to be effectual for some larger patients, particularly larger NJ patients used to larger doses overseas. Some respondents recommended taking double the dose and going to the doctor again for refill of the prescription, while others self-medicated with overseas supplements, and still others mentioned falling through the system entirely (particularly when it came to painkillers).
Joe Kurosu MD, who runs a clinic in Shimokitazawa, adds to this discussion in a January 2010 series of opinion pieces in the Asahi Shinbun, by saying:
Asahi: “For reasons that are unclear, however, the indicated maximum dose is often significantly lower than that which is standard in other parts of the world. Difference in physical frame and incidents of side effects are some of the purported reasons, but a scientifically convincing basis is lacking.
“A significant number of resident foreign nationals currently receive health care through the Japanese national health insurance system, but are ill-served because of these dosage standards.
“The maximum daily doses indicated on package inserts of standard medications for high blood pressure, diabetes and depression, for example, are one-quarter to one-half of the standard doses in other countries for the identical drug. […]
“In any case, if the government requires foreign nationals to join the [National Health Insurance] system, it must be willing to provide services appropriate to that population. If this is not possible, then buying in the system should be voluntary […] I urge the government and relevant authorities to return autonomy to the physicians so the medications can be prescribed appropriately for the patient, whether or foreign or Japanese, based on science and clinical judgment, rather than [mechanically applying the dosage levels indicated on the package inserts].”
Here are scans of Dr. Kurosu’s articles in English and Japanese, courtesy of Dr. Kurosu himself (pctclinic.com) and RJ.
There was another question as to whether Japanese medical testers screen for Japanese as an ethnicity (or “race”) when it comes to clinical trials. Well, yes they do — as demonstrated here in Hawaii when I saw an ad in our campus newspaper back in 2012 calling for “Japanese” people to volunteer for a series of clinical trials “to help Japanese people”, sponsored by Covance. I inquired (as a Japanese citizen), but was told that they were only interested in “ethnic Japanese” (including those who didn’t have Japanese citizenship, but had “Japanese blood”). Oh well. Missed out on my body mass.
Many thanks to everyone for helping make Debito.org a valuable resource and forum. Dr. Debito Arudou
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