Page 1

JAPAN HEALTH

Local mat ters


Local Matters


Local Matters

Health and Wellbeing Our interactions with everyone and everything around us affects how we manage our health, our expectations for treatment, the way we interact with doctors and the way we behave.

4

JAPAN HEALTH NOW . LOCAL MATTERS


The relationship that the Japanese nation

Japan Health Now explores the forces behind

have with its health is evolving thanks to a

the changing healthcare landscape in Japan.

combination of socio-cultural, economic and

It outlines the increasing possibilities that

environmental factors. It is changing the

are opening up for health brands to get in

disease landscape, the health ecosystem, the

sync with Japanese people when it comes to

relationship patients have with their doctor

managing their health.

and how engaged they are in managing their health. This presents new challenges and opportunities for healthcare providers who need to rethink their relationships with patients and healthcare professionals in Japan.

5


What we see 1. Hampered healthcare As people live longer, it is more difficult to keep Japan’s growing elderly population healthy. All eyes are on Japan to see how it responds to this mounting challenge.

2. The fight for fitness The Japanese nation has become increasingly health conscious. People are spending more time and money looking after their physicial and mental wellbeing.

3. Digital dimensions Digital technology has helped fuel a new confidence amongst people to take responsibility for their own health.

6

JAPAN HEALTH NOW . LOCAL MATTERS


4. The disputed divine The traditionally paternalistic relationship between doctors and their patients is changing. Empowered patients want a greater say in how their health is managed.

5. Consultation conversion Mobile has made it possible for healthcare to be practiced virtually anywhere. Healthcare is no longer confined to the doctor’s office or hospital.

6. Courteous customisation Technology has opened up new channels for the pharmaceutical industry to interact with doctors. It has made it possible to adopt a more customised approach to marketing.

7


Hampered healthcare An age old question Japan has the world’s oldest population and

It is also symbolic of the nation’s desire to

people are increasingly living longer. The

continue moving smoothly as it faces the

ageing of the population has been brought

demographic challenge ahead.

about by low fertility and high life expectancies.

emphasis is being placed on individuals

Thanks to a combination of lifestyle, diet,

taking responsibility for their own health. The

genetics and affordable healthcare, Japan has

new paradigm of ‘life-style related diseases’

historically been one of the world’s healthiest

has emerged, reflecting the power people

societies. Unfortunately, as people live longer

have to control their own destiny when it

lives, they are more prone to diseases and

comes to health and wellbeing.

health conditions such as cancer, stroke, Alzheimer’s and dementia. New medical challenges are in the spotlight, such as The Locomotive Syndrome, an umbrella term coined in Japan to describe the physical weakness that comes from ageing joints and muscles.

8

In an attempt to improve the outlook, greater

JAPAN HEALTH NOW . LOCAL MATTERS

All eyes are on Japan as other nations observe how it responds to the challenge of caring for a large and expanding elderly population.


In 2013, a baby was born every 31 seconds in Japan and someone died every 25. This six second difference helped prompt the biggest natural fall on record in Japan’s population.

31 seconds

25 seconds

Source: Ministry of Health, Labour and Welfare

9


An age old question Japan has one of the highest concentrations of centenarians, with the number now increasing at approximately 10% per year:

51,376 25,606 10,000

153

1965

1998

2005

2012

Source: The Guardian, Japan’s centenarian population reaches more than 50,000

Demand for medical care in Japan is expected to triple in the next 25 years

25 YEARS

Source: The Washington Post, Japan’s Health-Care System Has Many Advantages, but May Not Be Sustainable

10

JAPAN HEALTH NOW . LOCAL MATTERS


So what? Getting up close and personal with people reveals how emerging ‘lifestyle diseases’ affect everyday lives of the Japanese nation. Spending time with people as they go about their daily activities helps develop an understanding of the cultural significance of products, services, medical conditions and treatments.

11


Hampered healthcare western reflections Changes in dietary habits are also threatening

As the prevalence of obesity and diabetes

the Japan’s position as the worlds’ healthiest

rises, Japan slowly begins to look a bit more

nation. There is increasing concern about the

like its western peers.

deterioration in diet with the rising popularity of fast food. For example, KFC has become the self proclaimed king of Christmas by aggressively marketing its fried chicken as a Christmas meal. Whilst people may only eat KFC once per year, the odd tradition has led to such high demand for the Colonel’s fare that preorders for Christmas begin in early December.

12

JAPAN HEALTH NOW . LOCAL MATTERS


Since 1976 there has been a 200% increase in the rate of obesity in men, whilst there has been no change in women over the same period. The discrepancy can be explained by women being more responsive to health interventions, as well as their desire to look good.

1976

2014

200%

Source: Ministry of Health, Labour and Welfare, Overview of the National Health and Nutrition survey results

13


Japan has the second largest number of McDonald’s branches after the US

Source: Wikipedia, list of countries with McDonald’s restaurants

14

JAPAN HEALTH NOW . LOCAL MATTERS


kcal The average Japanese person eats about 25% fewer calories per day than the average American

kcal

JAPAN

USA

15


The fight for fitness A shifting focus

But it is not all doom and gloom. The

Increasing health engagement is being

Japanese nation is becoming increasingly

facilitated by government policies to deliver

health-conscious and there is a focus on

education and intervention. Access to

disease prevention. People believe they have

over-the-counter medicines has improved

the power to change their own level of health

and regular check-ups and screening

and are spending more on health

programs are the norm to provide better

and wellness.

early prevention. The popularity of drug

There is a desire to stay healthy by engaging in activities that refresh mind and body: Japan is undergoing a running craze; it makes daily life more enjoyable, gives a sense of purpose and has become akin to something cool. Peo足ple in Japan devour any prod足uct with brain-related claims, reflecting a desire to seek products which improve their lives with a real or perceived function or experience.

16

JAPAN HEALTH NOW . LOCAL MATTERS

stores means that they are one of the fastest growing retail channels.


Waistline limits for citizens aged 40 to 74

33.5

inches

35.4

inches

Source: PolicyMic, Japan Has Cut Obesity to 3.5% in a Controversial Way That Wouldn’t Fly in America

Attempts by the Government to halt the

Contrary to the rise of fast food popularity,

spread of obesity include setting waistline

health-focused restaurants have emerged in

limits for citizens aged 40 to 74. Men

Tokyo called ‘doctor’s restaurants’. These

must maintain a waistline at or below 33.5

restaurants offer doctor certified menus

inches; for women, the limit is 35.4 inches.

which provide a choice of healthy meals

Counselling and support is mandated for

for those following diets, or for specific

anyone straying outside of these limits,

conditions such as diabetes.

although in practice this is rarely enforced.

17


A SHIFTING FOCUS

18

JAPAN HEALTH NOW . LOCAL MATTERS


The Japanese visit a doctor nearly 14 times per year, compared to 5 visits in the US and UK

JAPAN US UK

Source: OECD Publishing, Health at a Glance 2013, page 87

So what? There has never been a better time for brands to shape future wellness in Japan and help people live healthier lives. By understanding what really matters to people, brands can play a vital role in improving quality of life and delivering better health outcomes.

19


Digital Dimensions Challenging a “silent� society In a technologically advanced country like

Due to a rise in smart phone usage, Japan

Japan, it is no surprise that digital channels

became the largest purchaser of apps in

are helping facilitate healthy behaviours.

2013, surpassing the US. There are millions

Digital is empowering people and challenging the stereotype of the passive Japanese patient. It is increasing access to information and giving patients a new confidence to manage their own health.

20

JAPAN HEALTH NOW . LOCAL MATTERS

of downloads in Japan attributed to health and fitness apps alone.


Over 2 million downloads on iTunes

The fitness tracking app, Runtastic, has generated over 2 million downloads from iTunes alone. Runtastic tracks all activities from running to kayaking. Users can connect with one another – and can even cheer one another on via earpieces.

37%

of people in Japan use the internet as the main source for health and medical information

Source: Ministry of Internal Affairs and Communications

21


Challenging a “silent” society

Social media can provide anonymity to talk more openly about conditions such as depression and other mental illnesses, which remain taboo subjects in Japan. Safe online spaces have emerged where people can share stories and seek support whilst “keeping face”. Until recently, depression was only recognised within psychiatry to describe severe mental episodes. It took the pharmaceutical industry to coin the term ‘kokoro no kaze’ (the concept of your soul catching a cold) and to provide a cure through modern antidepressants for depression to be recognised in Japanese society. Most accounts on Japan’s social network sites such as Gree, Mixi and Line are anonymous – it is not who you are friends with, but what you know that matters. This means people can quickly become mini medical experts, using their knowledge to self diagnose, identify the right course of treatment and advise others.

22

JAPAN HEALTH NOW . LOCAL MATTERS


So what? Digital provides possibilities for companies to talk to the Japanese nation more openly about their health. It allows a habitually private nation to share their innermost aspirations and fears, activating invisible or latent consumer needs. Brands can get more in tune with people by understanding what they ‘feel’, ‘think’ and ‘do’ in relation to their health.

23


The disputed divine Transforming the Doctorpatient dynamic The digital revolution is also having an impact on the patient-doctor relationship. Traditionally, Japanese culture has been largely deferential to those in authority. As such, patients once afforded doctors a “god-like� status, following their instructions without question. It was common practice for patients to be unaware what medication they were taking, with medicine prescribed in unmarked bottles.

24

JAPAN HEALTH NOW . LOCAL MATTERS


This once paternalistic relationship is undergoing change as patients want a greater say in how their health is managed. The rise of digital formats relinquishes doctor control, allowing patients to play a more proactive role in decision making about their own health. Patients no longer blindly follow what their doctor says. Whilst they will not complain, they will switch doctors if they are dissatisfied and have freedom to consult any primary care doctor. This has led to long waiting-room times to see a preferred doctor.

The concept of the passive patient was most starkly demonstrated with the death of Emperor Hirohito in 1989 who, in spite of his status, was kept in the dark about his terminal cancer.

25


30% of outpatients and 32% of inpatients have sought a second opinion

Source: MHLW Patient’s Behavior Survey 2011, page 16

26

JAPAN HEALTH NOW . LOCAL MATTERS


71% prefer a collaborative role in the treatment decision between doctor and patient

So what? The Japanese are increasingly finding their voice in decision making about their health. Access to education and knowledge means that people have more choice and will increasingly seek treatments and brands that deliver on their promises.

Source: BMC, Patients’ preferences for involvement in treatment decision making in Japan

27


Consultation conversion Rise of the machines Mobile health is also playing an increasingly

Many doctors use smart devices to

important role for healthcare providers. The

search for medical information, manage

number of smartphones and tablets used by

patient information and facilitate remote

doctors has grown in recent years.

communication. Doctors refer to online sources to help with diagnosis and are frequent users of online medical communities.

28

JAPAN HEALTH NOW . LOCAL MATTERS


% of doctors who access online medical communities

Japan

78

China

55

India

54

Russia

52

Spain

48

USA

47

UK

40

Germany

39

Brazil

29

Italy

15

France

9

Online medical communities give rise to virtual thought leaders who operate in the digital space

Source: PMLiVE, Doctors in BRIC countries more likely to use social media than those in Europe

29


Use of smartphone vs. tablet (%) Searching for medical reports

26

47

Collect information about drugs and treatments

35

42

Read medical news

37

44

For apps useful in clinical situations

24

27

Communication with patients

5

9

Communication with doctors

9

8

Source: CareNet.com, 2013

30

JAPAN HEALTH NOW . LOCAL MATTERS


31


Courteous customisation Merging traditional and modern rep-Doctor interactions Technology is also changing how doctors

Tightening of rules around entertainment and

interact with the pharmaceutical industry.

restrictions on hospital visits has prompted

For many years selling drugs to doctors was

the pharmaceutical industry to turn to digital

based largely on a personal bond with the

interfaces to reach doctors.

medical representative.

Japan is leading the way in “e-detailing� to

Global market forces have prompted the

interact with doctors virtually. Doctors can

need for a new sales model. Declining sales

access company websites or portals to keep

forces and increasingly time pressed doctors

up to date with product information.

restricts rep access.

32

JAPAN HEALTH NOW . LOCAL MATTERS


Average rep visit (minutes)

9

1.5

JAPAN

USA

Focused more on exchanging pleasantries than product information Source: Eye for Pharma

So what? The relationship between the pharmaceutical industry and doctors is in a state of flux. Digital offers new ways of talking to the medical community. It offers the opportunity for greater customisation by getting the right message to the right doctor at the right time.

33


So what matters for Health brands? Adopt a patient-centric approach by exploring what people ‘feel’ ‘think’ and ‘do’. Activate invisible latent consumer expectations by getting up close and personal with people. Seek ‘outsights’ by leveraging knowledge from outside of the sector and beyond the border. Customisation and differentiation will ensure patients ‘opt-in’ to your brand. Use digital to uncover consumer truths about sensitive health and personal issues. Find new ways of maintaining a human-to-human relationship with doctors and other healthcare professionals.

34

JAPAN HEALTH NOW . LOCAL MATTERS


Find out more » To learn more about Japan Health Now, please get in touch:

Office contacts BOSTON » boston@hallandpartners.com Cape Town » capetown@hallandpartners.com Chicago » chicago@hallandpartners.com Johannesburg » johannesburg@hallandpartners.com London » london@hallandpartners.com Los Angeles » losangeles@hallandpartners.com Melbourne » melbourne@hallandpartners.com MUMBAI » mumbai@hallandpartners.com New York » newyork@hallandpartners.com Salt Lake City » saltlakecity@hallandpartners.com Seattle » seattle@hallandpartners.com Shanghai » shanghai@hallandpartners.com Singapore » singapore@hallandpartners.com Sydney » sydney@hallandpartners.com TOKYO » tokyo@hallandpartners.com

www.hallandpartners.com

/hall-&-partners /hallandpartners

/hallandpartners /hallandpartners

/hallandpartners


JAPAN HEALTH

www.hallandpartners.com

Japan Health Now  
Japan Health Now