HEALTH
Japan's Fee Shift and Cholesterol Control
JapanWed Sep 16 2026
Japan is seeing a rise in older citizens. Many of them have dyslipidemia, a condition that raises the chance of heart disease. The number of cases keeps growing as the population ages.
In 2024 the country changed its insurance fee categories. The new system was designed to encourage a whole‑person approach and to involve patients more in their treatment plans. Officials hoped this would improve long‑term health outcomes.
Researchers examined a large set of medical claims. They included adults with a dyslipidemia diagnosis and at least one cholesterol measurement. The study used the ICD‑10 code E78 to identify patients. It covered almost 590,000 individuals and more than 23 million visits.
The analysis showed that LDL cholesterol goals were met in 58.3 percent of visits before the change and 58.5 percent after. Patients with existing heart disease had lower attainment despite frequent use of statins and combination therapy. The most common drugs were statins, often combined with ezetimibe or fibrates. Overall lipid levels were similar across the two periods. Rates of heart attacks and strokes were comparable, but the data after the change covered only about six months.