The economic issue of vascular access within the Japanese medical reimbursement system.

We analyzed the current health economics of vascular access (VA) procedures in Japan. Results showed that the yearly VA-related medical expenses were as high as JPY20 billion and accounted for 1.4% of the total healthcare cost for chronic renal failure. The United States Renal Data System (USRDS) statistics showed that in the USA the yearly VA-related medical expenses accounted for 1.2% of the total medical cost for chronic renal failure, indicating that the costs did not differ much between the two countries. Moreover, percutaneous transluminal angioplasty (PTA) accounts for approximately 60% of VA procedures performed in Japan, and this ratio is increasing every year. Due to the aging of society and longer treatment periods, it is thought that PTA will become a significant procedure for the treatment of chronic renal failure in Japan.