Moral hazard during the lifestyle disease management: analysis of epidemiological data and questionnaire survey

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K21653
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Epidemiology and preventive medicine; Hygiene and public health
• Research Institution: National Center for Global Health and Medicine
• Principal Investigator: SUGIYAMA Takehiro 国立研究開発法人国立国際医療研究センター, その他部局等, 室長 (20725668)
• Research Collaborator: Imai Kenjiro ; Goryoda Sayuri
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 医療政策 / 疫学研究 / 生活習慣病

Outline of Final Research Achievements

We collected information with regard to “moral hazard” and “adverse selection “ during the care of lifestyle diseases and information that can facilitate the discussion. In the questionnaire survey, current statin users did not experience weight gain when they started statin therapy, which did not support the occurrence of moral hazard in this case. About 40% of statin users or SGLT2 inhibitor users answered that they might stop taking these drugs if these drugs were no longer reimbursed. These patients may be in the situation of moral hazard or adverse selection because they may have changed their dietary behavior when insurance coverage was changed. More than 80% of people without these drugs were supportive about reimbursement of pharmacotherapy for the lifestyle diseases. These results can be important when policymakers plan to change the insurance scheme of these drugs.

Free Research Field

ヘルスサービスリサーチ

Academic Significance and Societal Importance of the Research Achievements

保険がなければ投薬を受けないと回答した人が約4割いた一方で、一般の認知としてはモラルハザードが起きる可能性について含めても生活習慣病薬に対する保険適用は行うべきであるという意見が大勢であった。これらの知見は、モラルハザードや逆選択の視点から保険制度を考える上で重要な情報であると考えられた。その他にも、米国における小児肥満・過体重の定義変更前後での肥満認識変化、糖尿病有病者数と糖尿病性腎症による透析導入者数の将来予測などについて研究を行い、今後の政策立案に資する知見を得て、英文学術雑誌に出版した。