OBJECTIVES: The Japanese national medical care expenditure is increasing, and it exceeded 43 trillion yen in 2017. In FY 2016/2017, a pilot implementation for the economic evaluation of pharmaceuticals and medical devices was conducted to provide efficient health care and pricing of health technology. Then, a new full-scale process was implemented in FY 2019. A survey for the outsourcing of these pilot and full-scale implementations was conducted to clarify the executing institutions, participation requirements, and costs.

METHODS: Disclosure of administrative documents related to outsourcing contracts for public cost-effectiveness analysis was requested from the Japanese National Institute of Public Health (NIPH). The requested documents’ period was from the beginning of the pilot phase to the end of June 2019. Relevant information about each item was summarized in tables.

RESULTS: Outsourcing contracts were signed with seven universities, one national institute for pilot implementation (16 items), and with two universities for full-scale implementation (50 items). The unit costs for the pilot and full-scale implementation were approximately US$55,000 to $124,000 and approximately $226,000, respectively. Contracts were not awarded through competitive bidding, but they were discretionary. Participation requirements for competitive bidding were stipulated: a university or a national research and development agency that has experience in public cost-effectiveness analysis, no conflict of interest (COI) in the analysis target, and researchers participating in these analyses are approved by the Center for Outcomes Research and Economic Evaluation for Health, NIPH.

CONCLUSIONS: The implementation of a cost-effectiveness evaluation is cost-incurring. To implement it smoothly and sustainably, it is necessary to ensure the validity, accountability, and competitiveness of the outsourcing costs. It is important to act and/or re-consider the participation requirements for competitive bidding as soon as possible, to increase the number of universities and institutions that have experience in public cost-effectiveness analysis.