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日本醫(yī)療奇跡有待走出實(shí)驗(yàn)室

日本醫(yī)療奇跡有待走出實(shí)驗(yàn)室

Michael Fitzpatrick 2013-04-11
日本是世界上人口老化程度最高的國(guó)家之一,因此,涉及養(yǎng)生保健領(lǐng)域的科研和技術(shù)十分活躍。現(xiàn)在,日本政府正希望把醫(yī)療變成日本新的支柱產(chǎn)業(yè)之一。

????世界上第一款可以承受消毒處理的柔性有機(jī)晶體管;只要攝下面部畫(huà)像便可測(cè)定脈搏的移動(dòng)應(yīng)用;不光能照出人體骨架、還能照出人體內(nèi)癌變組織的X光機(jī)。——這些僅僅是日本目前正在開(kāi)發(fā)的技術(shù)中的一小部分。眼下,這個(gè)國(guó)家已經(jīng)圍繞著國(guó)人傲視全球的長(zhǎng)壽記錄發(fā)展出了一個(gè)行業(yè)。那我們?yōu)槭裁礇](méi)有在醫(yī)療器械或其他醫(yī)療相關(guān)產(chǎn)品上看到更多的“日本制造”字樣呢?

????據(jù)某些權(quán)威人士表示,原因就出在所謂的“死亡谷綜合癥”(Death Valley Syndrome)上。或者說(shuō),日本的創(chuàng)新,在研發(fā)階段還活力四射、前景可期,卻很少能夠跨過(guò)科研與商業(yè)化之間的那道坎兒。就如一位不愿透露姓名的官方人員所形容的,日本“精于技術(shù),但不懂經(jīng)營(yíng)”。“日本高水平的基礎(chǔ)研究和卓越的技術(shù)被過(guò)于嚴(yán)苛的管制、縱向一體化的管理捆住了手腳。科研人員和制造商之間的代溝在很多時(shí)候都阻礙了杰出的研發(fā)成果投入到實(shí)踐的進(jìn)程,也就是所謂的‘死亡谷’難題。”

????日本研制的藥物融入了若干最高水平的創(chuàng)新成果、專業(yè)精神以及隨處可見(jiàn)的關(guān)懷心,外界目前普遍認(rèn)為它尚未得到充分開(kāi)發(fā)。結(jié)果導(dǎo)致日本在藥物及醫(yī)療器械領(lǐng)域出現(xiàn)了貿(mào)易逆差。日本去年的藥物進(jìn)口總值比出口總值高出了1萬(wàn)億日元。這正是安倍晉三帶領(lǐng)的新任政府班子希望立刻解決的問(wèn)題。

????今年2月,東京政府宣布計(jì)劃設(shè)立“健康醫(yī)療戰(zhàn)略室”,職責(zé)是將日本某些十分優(yōu)秀、但日漸式微的科研成果帶入市場(chǎng)。這個(gè)研究室的宗旨是樹(shù)立日本在醫(yī)療技術(shù)及保健服務(wù)領(lǐng)域的世界領(lǐng)先地位。這位新任的日本首相對(duì)于這個(gè)板塊的潛在實(shí)力充滿了信心,將這一政策納為他所說(shuō)的“安倍經(jīng)濟(jì)學(xué)”(Abenomics)政策計(jì)劃“三支箭”中的一支,意圖重振日本疲軟的經(jīng)濟(jì)。剛剛在上月設(shè)立了健康醫(yī)療戰(zhàn)略室的日本內(nèi)閣官房長(zhǎng)官菅義偉稱,安倍政府計(jì)劃“將醫(yī)療板塊、藥品、醫(yī)療設(shè)備及器械產(chǎn)業(yè)打造成日本的戰(zhàn)略性產(chǎn)業(yè),日后成為日本經(jīng)濟(jì)復(fù)興的重要支柱。”

????此外,放開(kāi)了管制的地區(qū),譬如延伸至東京周邊多個(gè)城市的大片海岸,已被指定為開(kāi)發(fā)特區(qū),專門(mén)用來(lái)幫助科研創(chuàng)新成果走出實(shí)驗(yàn)室,把它們交到私營(yíng)企業(yè)的手中。特區(qū)內(nèi)的實(shí)驗(yàn)室和企業(yè)機(jī)構(gòu)可以享受稅務(wù)減免和政府基金支持。官方人士表示,日本其他地區(qū)在醫(yī)療測(cè)試方面施行的嚴(yán)格管制條款在這里也會(huì)變得更加寬松。

????截至目前,放開(kāi)管制的地區(qū)已經(jīng)令一種先進(jìn)的外科手術(shù)模擬器的開(kāi)發(fā)成為了可能。這種模擬器能讓缺乏經(jīng)驗(yàn)的醫(yī)生接受虛擬環(huán)境下的模擬手術(shù)訓(xùn)練,而不用拿人體來(lái)做“小白鼠”。其他一些企業(yè)則聯(lián)合開(kāi)發(fā)了一組小型的家用超聲波套件。目前,研發(fā)項(xiàng)目所在地橫濱已經(jīng)不再列入禁止家用超聲波設(shè)備的管制地區(qū)名單,因此超聲波在家庭中的臨床應(yīng)用開(kāi)始變得可能。

????醫(yī)療政策室的一位干事中垣英明表示,日本的醫(yī)療技術(shù)也會(huì)大力進(jìn)行海外宣傳。“健康長(zhǎng)壽領(lǐng)域存在著一個(gè)巨大的市場(chǎng)。我們之前關(guān)注的一直是國(guó)內(nèi)市場(chǎng),但是如今我們也要開(kāi)始把重心放在海外市場(chǎng)上。”他還補(bǔ)充說(shuō),他所在的委員會(huì)應(yīng)該會(huì)在今年夏季時(shí)拿出具體的相關(guān)政策方案。

????The world's first sterilizable, flexible organic transistor; mobile apps that can measure your pulse just by imaging your face; X-ray machines that capture not just bone but cancer tissue, too. These are just a few of the technologies being developed in Japan now, where an industry has grown around the world-beating longevity of the country's people. So why don't we see "Made in Japan" stamped more often on medical instruments or other products in the medical field?

????The answer, according to some pundits, is the so-called Death Valley Syndrome. In other words, Japanese innovation, full of vitality and promise at the R&D level, rarely makes it across the perilous divide between research and commercialization. Japan is "good at technology but poor in business" as one official who declined to be named puts it. "Its high levels of basic research and superior technology are hampered by too-strict regulations, vertically integrated administration. And the gap between researchers and manufacturers is, in many cases, preventing brilliant R&D results from being put into practical use -- the 'Death Valley' problem."

????Practicing some of the highest levels of innovation, professionalism, and care seen anywhere, Japanese medicine so far has been famously under-exploited. As a result, Japan's imports of medicines and medical equipment trounces exports. The country's medicine imports exceeded exports by about 1 trillion yen last year. That is something the newly elected government, led by Shinzo Abe, means to fix immediately.

????In February, Tokyo announced that it would establish an Office for Health Care and Medical Strategy charged with getting some of Japan's exceptional but languishing R&D efforts to market. The office aims to establish Japan as the most advanced in medical technologies and health care services in the world. The P.M., so sure of the potential strength of the sector, has made it one of the "three arrows" of his so-called Abenomics policy plan to revive Japan's flagging economy. The government aims to "develop the medical sector, pharmaceutical products, and medical devices and equipment as strategic industries that will form a key pillar for Japan's economic revitalization," says chief cabinet secretary Yoshihide Suga who launched the health care office last month.

????In addition, deregulated areas, such as a large stretch of coast that straddles Tokyo's neighboring cities, have been designated special zones dedicated to getting innovation out of the labs and into the hands of private companies. Tax breaks and government funds are available to labs and firms in the region. Strict regulations that apply elsewhere in Japan on medical trials are looser here, say officials

????So far the deregulated zone has made it possible to develop an advanced surgery simulator that allows inexperienced doctors to perform simulated surgery training, virtually, without the need for human guinea pigs. Other companies have jointly developed an ultrasound kit miniaturized for home use. Clinical trails at home were made possible because the site, Yokohama, now falls outside Japan's regulated zone that would ban home use.

????Japanese medical technology is also to be aggressively marketed abroad, says Hideaki Nakagaki, a director general of the Office of Health Care Policy. "There is a huge market here for health, longevity. We were looking at the domestic market, but now we will be focusing on overseas sales, too." His committee should have concrete policies on this subject by summer, he adds.

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