Market Overview

Statutory health examinations include municipality-provided checkups for residents, periodical checkups provided by corporations to employees, tuberculosis/cancer screening, health examinations under the Maternal Health Act or the School Health and Safety Act, and checkups for latter-stage elderly people (those aged 75 and over). Another statutory is specific medical checkups geared to anyone insured by public health insurance at the ages between 40 and 74 and are conducted since 2008, aiming to detect and treat lifestyle diseases from early stages. There also are some medical examinations that can be taken optionally, including comprehensive ones. The health checkup and comprehensive medical examination market in this research targets all the above.

Japan has set as the national policy to extend healthy life expectancy and to achieve independent wellbeing of old people by addressing pre-symptomatic state and disease prevention. In the short-and mid-term roadmap for “Growth Strategy 2017”, the government's target was 80% as a KPI for medical examination rate for the population at ages between 40 and 74 by FY2020.
However, according to the Comprehensive Survey of Living Conditions for FY2022 by the Ministry of Health, Labour and Welfare (MHLW), the rate of men and women aged between 40 and 74 who received health checkups (including periodic checkups and comprehensive health examinations) for the past year accounted for 73.1%, failing to reach the target, though the rate has been on a gradual rise.

In addition, according to the data at MHLW, the rate to take specific medical checkups and specific health guidance accounted respectively for 56.5% and 24.6% for FY2021, indicating a lingering gap from the governmental targets that are respectively 70% or more and 45% or more, though improving year by year. This has led to a policy to review the examination rate target and to change standard questions and items in these specific checkups and guidance, to introduce outcome assessments for the above guidance, and to apply ICT, which are aimed to be reflected from FY2024. Health checkup facilities and insurers (health insurance associations, etc.) are required to provide checkups effectively and efficiently.

Noteworthy Topics

Optional Inspections Not Included in Standard Comprehensive Medical Examinations Becoming a Factor to Differentiate from Other Facilities

It seems that facilities providing health checkups have been addressing to attract more examinees by introducing optional inspections that respond to examinee needs, making it one of differentiating factors from other facilities. A mailed questionnaire for this research has been conducted to health checkup facilities from August to September, with 106 respondents having answered back.

When asked in the questionnaire about popular medical inspections (allowing multiple responses) that can be taken optionally and are not included in a standard package of comprehensive medical examinations, “PSA (Prostate Specific Antigen)” obtained 46 responses, the largest number (43.4% of all respondents), followed by “Upper gastrointestinal endoscopy” gaining 41 responses (38.7%), and tumor markers “Carcinoembryonic Antigen (CEA)” and “CA19-9” respectively earning 34 responses (32.1%). Other examinations relatively popular were other tumor markers and those in the areas of gynecology and cerebral nerves.
When asked which field to focus on hereafter, many answered “comprehensive medical examinations” just like in the last survey in 2021, indicating the continued attention.

Future Outlook

The domestic health checkup and comprehensive medical examination market for FY2022 (based on the examination fee) was estimated as 937,000 million yen, 101.7% of the size of the previous fiscal year.
Before COVID, the market size tendency had been leveling off or on the slight rise, because of declining productive age population and increasing rate to take specific medical checkups. However, COVID-19 infections brought about reluctancy by examinees to take checkups and temporary suspension of health examination services, which reduced the number of examinees for FY2020 and shrank the market size to 91.4% on YoY. After FY2021, although influence of the corona crisis somewhat lingered, the market has been overall returned to the level before COVID.

Despite downgrading of COVID-19 to the class 5 infectious disease under the Infectious Disease Law, infection control measures are likely to remain at health checkup facilities for some time, particularly in the urban areas with dense population where the measures are indispensable. Shortening the time for medical examination can be the differentiation factor from other facilities.  
The corona crisis has triggered people to be more conscious of health and prevention, which is considered as the tailwind for the health checkup and comprehensive medical examination market. Just like it used to be, the market is expected to level off or to be on the rise, as the market for FY2023 projected to reach 944,000 million yen, 100.7% of the preceding fiscal year.

From the mid-to long-term perspective, the conventional way to take medical examinations that is to visit a medical institution for checkups and explanations can be innovated, as new efforts are underway, such as at-home checkups through mail and online reporting for the examination results. For health checkup facilities, it is important to understand the potential needs of examinees and to take into action.

Research Outline