Is Japan Leading a New Digital Health Movement?

Dave Hanaman, President, Chief Commercial Officer, Co-Founder, Curavit Clinical Research.

Japan’s digital health market is expected to show a compound annual growth rate (CAGR) of 7.29% from 2024 to 2028 versus 7.48% over the same period in the United States. Japan is catching some ground and it’s easy to see why. The island nation’s leadership in digital health reflects the country's unique blend of technological innovation, aging population, and proactive approach to healthcare challenges.

“Japanese-based pharmaceutical companies have been interested in digital therapeutics (DTx) for years,” explained Andy Molnar, CEO of Digital Therapeutics Alliance (DTA). “Shionogi formed a partnership with Akili in 2019, Sumitomo Pharma partnered with Realized Care (BehaVR, at the time) in 2021, and late last year, Daiichi Sankyo announced they plan to review as many opportunities in the DTx space as possible. What we are seeing now is the result of years of interest in this space.”

Just ahead of International Clinical Trials Day on May 20, let’s dive in to understand the factors that contribute to Japan's prominent position in this rapidly evolving field—and why it matters to the global life sciences industry.

A Flair for Technological Innovation

Japan is renowned for its technological prowess, with a long history of driving advancements in electronics, robotics, and computing. This technological foundation has naturally extended into the healthcare sector, where Japan has redirected its technology ingenuity to develop cutting-edge digital health solutions. In fact, the digital health market in Japan is expected to tower over China, reaching US $6.15 billion this year versus about $54 million in China.

From advanced wearables that monitor vital signs to sophisticated telemedicine platforms enabling remote consultations, Japan's technological innovation underpins its leadership in digital health. For example, Takeda developed a digital therapeutic app to help monitor Parkinson disease.

Patients with this disease experience tremors and other symptoms that fluctuate in severity throughout the day and can be challenging to describe. Continuous monitoring helps physicians develop effective treatment plans, but medical-grade monitoring devices are heavy and difficult for patients to wear 24/7.

Through a partnership with Kanagawa Prefecture south of Tokyo, Takeda created an integrated care solution called “Care for One.”The solution measures Parkinson disease symptoms via an app, using a program that Apple Watch built to capture movement disorders. Patients can enter additional medical information into the iPhone app and send comprehensive data directly to their doctor’s computer.

In another example, Sumitomo Pharma iscollaboratingwith US-based BehaVR to develop three virtual reality digital therapeutics addressing social anxiety disorder, generalized anxiety disorder, and major depressive disorder. The country's commitment to research and development, coupled with a robust ecosystem supporting innovation, has facilitated the emergence of such innovations aimed at improving healthcare delivery and patient outcomes.

Most recently, too, Japan-based Otsuka announced FDA approval of its digital treatment for major depression. Called Rejoyn, the smartphone-based treatment was developed with digital therapeutics company Click Therapeutics, and it’s intended for use by prescription, alongside antidepressants and cognitive-behavioral therapy. Otsuka is the first drug company to receive FDA clearance for a digital treatment for a mental health condition.

A Growing Elderly Population

One of the most pressing challenges facing Japan is its rapidly aging population. For the first time in the island nation’s history, more than one in 10 people are now 80 years of age or older, roughly 29% are 65 years of age or older, and by 2040, that percentage will skyrocket to 35%—including more than 300,000 centenarians.

Japan’s swelling elderly population creates unique healthcare challenges, including increased demand for long-term care and chronic disease management. Digital health technologies offer a solution to these challenges by enabling more efficient healthcare delivery, enhancing access to care for the elderly, and facilitating better management of chronic conditions.

DTx products, such as AI-powered diagnostic systems and mobile health applications, play a critical role in providing personalized and accessible care to Japan's aging population. For example, Japanese startup Iris built an AI-powered device called nodoca to diagnose influenza within seconds without painful nasopharyngeal tests or long waits in the office.

The company trained its AI model with more than 500,000 throat images, supplemented with information from a patient questionnaire to provide its diagnoses. The innovative tool offers elderly individuals—prone to influenza—with a more comfortable, accurate diagnosis.

A Move Toward Proactive Healthcare Policies

Since revising the Pharmaceutical Act in 2014, the Japanese government has been moving swiftly to upgrade its healthcare system with digital therapeutics and implementing forward-thinking policies and initiatives. The government has launched numerous initiatives over the years to promote the adoption of electronic health records (EHRs), telemedicine, and other digital health tools.

CureApp, a startup company pioneering digital therapeutics in Japan, received Japan's first regulatory approval in 2020 for its "CureApp SC" nicotine addiction treatment app, followed by the world’s first regulatory approval for hypertension in 2022 for its high blood pressure management application. These efforts are supported by policies aimed at creating a favorable regulatory environment for digital health innovation, including streamlining the approval process for digital health solutions and providing financial incentives for their adoption.

“In terms of demographics, there’s a good foundation for digital therapeutics in Japan to become as prevalent as that in the US,” said Naoyuki Kanda, business producer at Astellas Pharma in an interview. “When you look at specific disease areas and applications, digital therapeutics are advancing quite a bit. Two digital therapeutics are already receiving public reimbursement in Japan. When you consider all these factors, there’s big potential for the Japanese digital therapeutics market.”

Japan's success in digital health is also attributed to the collaborative efforts between the government, private sector, and academic institutions. This collaboration has facilitated the integration of digital health technologies into the healthcare system, ensuring that innovations are effectively translated into clinical practice. Public-private partnerships are instrumental in driving the development and adoption of digital health solutions to improve healthcare—and an area in which the United States is still developing.

“Many of the APAC countries can move quicker than the US when it comes to reimbursement,” added Molnar. “Clinical trials must be done on the Japanese population for market authorization in Japan, so we are seeing large growth in Japanese companies that are focused solely on the Japanese market. And you can see this through more local associations such as JaDHA (the Japanese digital health association). Japanese companies have big international footprints as well, so this will certainly influence global markets.”

A Longstanding Cultural Acceptance

The innate cultural acceptance of technology in Japan plays a crucial role in the adoption of digital health solutions. The Japanese population's openness to technology has enabled the rapid adoption of digital health tools, making it easier to integrate these technologies into everyday healthcare practices.

They were among the first to adopt technologies such as Nintendo’s Game Boy and Sony’s Walkman in the early 1980s, and today, Japan is a world leader in robotics where humanoid robots are commonplace in Japanese homes and workplaces, including healthcare settings. Today, the tide is turning again.

Japan's leadership in digital health is the result of a multifaceted approach that combines technological innovation, proactive healthcare policies, and a collaborative ecosystem. By addressing its demographic challenges through digital solutions and fostering an environment conducive to innovation, Japan sets a global benchmark in leveraging technology to enhance healthcare outcomes.

As digital health continues to evolve, Japan's experiences offer valuable lessons for other countries looking to harness the potential of technology to improve healthcare delivery and patient care.

About the Author

Dave Hanaman is co-founder, president, and chief commercial officer of Curavit Clinical Research, a virtual contract research organization (VCRO) that designs and executes decentralized clinical trials and specializing in digital therapeutics. He is a proven entrepreneur, operator, and board director. Founder of C3i, a Business Process Outsourcing (BPO) healthcare provider, Hanaman developed and led its sales, marketing, product development, and alliance strategies. He serves as a board member and advisor to several start-up and growth-stage companies in healthcare and technology. Hanaman graduated from the University of California at Berkeley and served as a deployed US Navy intelligence officer. He can be reached at dave.hanaman@curavitclinicalresearch.com