Japanese Makers Advance Efforts To Recycle Costly Medical Devices

Tokyo, 10 March 2018: Japan’s health-care industry is aiming to reduce waste, cut costs and catch up with its U.S. and German counterparts in the process by recycling single-use devices (SUDs) used in surgeries and other procedures.

If the novel approach spreads among medical institutions, in line with a government initiative, medical experts say it could help rein in the nation’s escalating medical costs.

Manufacturers and companies involved in cleaning and sterilizing SUDs formed a council in February to push the program.

The council comprises nine companies, including Japanese arms of U.S. remanufacturer of health-care devices.

“Our aim is the effective use of and safe management of medical products,” said Kenichi Matsumoto, director of the council, who also serves as chairman of Sakura Global Holding Co., which specializes in the cleaning and sterilization of medical devices, at a news conference in Tokyo on Feb. 2. “It will contribute to a reduction in medical waste.”

One of the council members is expected to market its first remanufactured SUD in fiscal 2018.

Recycling parts of medical devices had until recently been restricted to prevent bacterial infections and deterioration in their functionality.

Manufacturers clearly instruct in accompanying literature for SUDs that their uses are limited to one-time only, such as the electrical poles of an electrical scalpel used to remove tumors and a saw blade to cut through bone.

But some devices come with a price tag too high to be simply disposed of after being used only once.

For example, one special kind of catheter is priced as high as 200,000 yen ($1,869).

As a result, there have been persistent calls within the health-care industry to recycle SUDs.

SUDs can be reusable as long as they are cleaned and disinfected adequately, advocates said.

Noting the call, the Ministry of Health, Labor and Welfare put in place a system in July 2017 to recycle parts of SUDs and remanufacture them.

Under the system, companies can collect used devices to break them up into pieces and disinfect them thoroughly. Remade products can be sold with approval from the government after their quality and cleanliness are validated as equivalent to their new counterparts.

The council plans to start educating medical facilities about the new system and hold workshops on techniques needed to remanufacture SUDs.

The Japanese medical device market is worth approximately 2.7 trillion yen, according to Hogy Medical Co., a member of the council.

Disposable products account for about 1.5 trillion yen of the total. Some 10 percent of these products are deemed suitable for reuse, according to Hogy Medical.

The United States and Germany are ahead of Japan in terms of recycling SUDs.

In the United States, remanufactured versions are sold at 50-70 percent of the price of new products.

But there are many hurdles to be cleared before reuse of SUDs can become prevalent, health-care experts say.

For example, the degree of difficulty involved in thorough cleaning and adequate sterilization varies from one product to the next, depending on material and design features.

It is unclear at the moment to what extent companies will be asked to prove the quality of remanufactured SUDs, they say.

If the cost of remanufacturing turns out a lot more than initially expected, the new system may not take off.

The health ministry’s move to allow remanufacturing of SUDs was prompted after a string of cases surfaced in which medical facilities disinfected them on their own and reused them.

The ministry has repeatedly issued a directive for medical personnel to strictly adhere to instructions about SUDs provided by device makers.

Their reuse came to light in 2015, however, at Kobe University Hospital and Tokyo Medical and Dental University Medical Hospital.

In 2017, it surfaced that some hospitals in the Kansai region, including the Osaka International Cancer Institute, were also implicated in such a practice. The incidences of reuse stood at 435 at the Osaka International Cancer Institute since 2015 alone. The part most often reused were electrical poles of electrical scalpels, which cost about 20,000 yen per pole.

Now, the institute is taking exhaustive measures to prevent a recurrence. Workers were recently seen taking out bins filled with used devices one after another on the facility’s floor where operating rooms are located.

“Some devices seem good enough to be reused if they are disinfected properly, but we have no choice,” said a worker there.

Masaki Muto, professor of health-care management at the International University of Health and Welfare, said the new system will steer medical personnel to break with the practice of reprocessing SUDs on their own for reuse.

“If safer, remanufactured products are made available, reuse of SUDs will decrease,” he said. Asahi Shimbun