ALS Policy: A Japanese Perspective

The prevalence of ALS and the age at onset in Japan have been increasing in recent years. Japan has various insurance systems for incurable diseases, and financial assistance for medical care and care is generous. In some areas, there are long-term hospitalization facilities, but home medical care is substantial and many patients stay at home. The proportion of patients selecting tracheostomy ventilators is higher than in Western countries. Patients have access to any physician under public insurance and can participate in treatment trials. Large-scale ALS centers are difficult to establish, but multidisciplinary medical care is covered by insurance. The withdrawal of ventilators is not routinely performed in Japan and can be problematic in patients with advanced tracheostomy ventilators. The challenge is to train medical professionals who specialize in ALS.