The experts' forecasts of morbidity and mortality for each of the four diseases in Japan resulted in the modification of the standard estimates. It is clear that in addition to pharmaceutical advances, the experts valued investments in behavioral and other biomedical interventions and that such advancements would contribute significantly to better prevention and management of chronic disease over the next 25 years. Thus, they predicted a reduction in morbidity and mortality of the four diseases examined in the present study from the demographically based standard projections. The opinions from the experts who participated in the study have implied that Japan could significantly reduce health care costs by vigorous public health campaign in behavior and lifestyle changes toward better health and investment to medical technology advance including improvement of current drugs, development of new drugs and development of diagnostic and treatment devices. Despite these reductions due to behavioral and biomedical advances, overall, we predict a tremendous increase in the number of cases for each disease due to an increasing proportion of the elderly in the population.

The purpose of this type of forecasting is to provide a framework that contains a range of potential events or conditions that may be used to develop an informed discussion of important strategic choices and explicit judgments about the impact of long-term investments. At a time when Japan and many other countries are concerned about the rising costs of health care, it is essential that the short-term measures is not taken which may jeopardize future research and development effort. It is equally important that the research and development community focuses its resources on those areas in which the most benefit is expected from technological advance.

Publications and Presentations

Namekata T, Murakami Y, Hashimoto S, Ohashi Y, Okamoto E, Brown R, Luce B. Japan disease and economic forecast study: coronary heart disease, stroke, diabetes mellitus and lung cancer. Journal of Health and Welfare Statistics 1998; 45(1):1-7

Namekata T, Ohashi Y, Murakami Y, Hashimoto S, Brown R, Luce B. Japan disease and economic forecast (JDEF) study: Volume I. coronary heart disease, cerebrovascular disease, diabetes mellitus and lung cancer. The Internal Report of the Pacific Rim Disease Prevention Center 1996.

Namekata T, Ohashi Y, Murakami Y, Hashimoto S, Okamoto E, Brown R, Luce B. Japan disease and economic forecast (JDEF) study: Volume II. Hepatitis B and C virus-related diseases and dementia. The Internal Report of the Pacific Rim Disease Prevention Center 1996.