Asia’s traditional medicines industries, which include Japan’s Kampo medicines (KM) firms, continue to grow, with an estimated market value of over 100 billion USD. Consumed by half of the world’s population, Asian traditional medicines have also become increasingly global commodities. The potentially lucrative and largely untapped markets outside Asia have incentivized the Traditional Chinese Medicines (TCM) and Indian Ayurveda industries to implement strict, internationally-recognized standards or ‘good practices’ for drug manufacturing, efficacy, and safety. In Japan, however, domestic market circumstances were the driving force.
In this paper, I argue that the reasons why Japan’s KM manufacturers chose to modernize their manufacturing operations and comply with internationally-recognized standards were fundamentally different from those of their Asian counterparts. Japanese KM manufacturers were motivated by three domestic policy changes: (1) inclusion and coverage of Kampo medicines in the National Healthcare System from 1976, (2) the introduction of free healthcare—including medications—for the elderly in 1973, and (3) prescription practices, which encouraged physicians to over-prescribe. This paper explores how this policy framework governed the domestic manufacturers’ strategy choices, influenced physician and patient behaviors, and shaped wider societal perceptions of traditional medicine as an integral and inseparable part of Japan’s modern healthcare system.
The paper is based on a book chapter, whose tentative publication date is December 2021. It was co-authored with two specialists: a pharmacologist who spent much of his career at Japan’s largest KM manufacturer, and a physician, who worked at WHO to help create the system now used to classify traditional medicines. Their firsthand perspectives on this complex industry and our use of a vast array of scientific, historical, and regulatory policy sources, both in English and Japanese, help to elucidate the Japanese KM industry’s course of development from the 1970s to the present and its distinctive features.