Physicians often run (and sometimes own) local hospitals in Japan. Because of this, they are the key decision makers for most major hospital purchases. Thus, it is imperative that a manufacturerâ€™s medical device appeals to Japanese doctors during both the pre-approval and marketing phases.
How do Japanâ€™s all-powerful doctors decide what products to purchase? The influence of universities plays a large role. Japanese doctors also tend to maintain loyalty to their former professors and medical schools throughout their careers. Hence, purchasing decisions often follow the recommendations of universities and professors, rather than individual doctors’ judgment. This type of influence can work either for or against a medical device company. For example, acceptance of a medical device by a leading doctor or professor basically guarantees that former students will choose it when purchasing decisions arise. On the other hand, rejection can be complete and across the board. In addition, interschool rivalry can play a role. If one school accepts a medical device, a competing school may reject it, for no reason but the rivalry between them.
Therefore, choosing an inappropriate school/physician to approve a medical device can greatly reduce its chances for registration, reimbursement, and widespread adoption in Japan.