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Obtaining the certification to affix the JIS mark to medical wigs is the first step in aiming at health insurance coverage of medical wigs

Wearing a medical wig makes patients suffering from hair loss due to anticancer drugs, etc. smile and helps expand their sphere of action.On the other hand, it also generates disruption. What are medical wigs? How should you choose a medical wig?Then, an activity for obtaining the certification to affix the JIS mark to medical wigs has started.

Formulate standards for choosing a suitable medical wig by consumers

What is the definition of medical wig?

Basically, there is no product called as a medical wig. At present, each company markets wigs as medical wigs at their own discretion. Thus, consumers do not know which wig they should use. A person who visits to consult with company A purchases a wig provided by company A, while a person who visits company B buys one provided by company B. When asked, "Which one is better?", you do not know which one. There are some consumers who have trouble choosing it. For example, both company A and company B make excellent wigs, while company D and company F may make poor quality wigs which patient do not know, much less physicians. Thus, we, physicians, do not know which one to recommend, which is a problem that has recently arisen.

What values does JIS mark certification affixed to medical wigs have?

Under these circumstances, many people concerned with medical wigs including healthcare professionals and users gathered together headed by the Japan Hair Industry Association in order to develop unified standards for medial wigs. I thought this movement was quite favorable.This is because a wig comes in a direct contact with the skin and a wig is a kind of product which is useless if it is only stout. Thus, its safety is emphasized, that is, it causes no rash. We thought that we should investigate how safe they are. We investigated patients with alopecia caused by anticancer drugs at the time of inauguration of the Committee. However, we found that it was not sufficient to investigate only these patients, because people also suffer from hair loss permanently due to head irradiation. Also, there is a type of alopecia areata in which all scalp hair is lost although speaking of alopecia areata , you surely imagine small bald patches. We also added such patients with severe alopecia areata in our study. Although its frequency is low, one out of several hundred thousand people, there are children born with thinning hair caused by a genetic abnormality. Medical wigs must be the one which such children can use. First, the Committee started to consider for what indications medical wigs obtain JIS mark certification in case that the above patients use it.

Which stage are you in now?

Group meeting is frequently held; the general committee was already convened twice this year. The final committee will be held in coming June in order to finalize the draft JIS certification and submit it to the Ministry of Economy, Trade and Industry. If we obtain the certification to affix the JIS mark to medical wigs, the performance of wigs including its safety is guaranteed even if using a wig from any wig manufacturer. Thus, patients can feel safe to purchase it. Medical wigs contribute to the improvement of patients' QOL

Medical wigs contribute to the improvement of patients'

I think that medical wigs give patients great psychological comfort.

Recently, patients' QOL (Quality of Life) has been increasingly emphasized in clinical practice.
When a patient undergoes breast cancer surgery, she receives breast reconstruction. This procedure is regarded as a medical procedure and thus is covered by health insurance. As the medical procedure keeps evolving, breast implants which have so far been used in the field of plastic surgery, silicone implants have recently become covered by health insurance. Now that beauty treatment and medical treatment are integrated and when thinking in that way, improving QOL becomes important without doubt. For example, endoscopic surgery has so far required at least one week hospitalization and now a patient is discharged from the hospital in three days. Realization of early ambulation means an obvious improvement in QOL. Moreover, surgical wound can barely be noticed. Patients' QOL has been increasingly placed emphasis on in healthcare field and medical devices keep evolving.
Wigs also are valuable in that they contribute to the improvement in patients' QOL. If only there are standards which guarantee the minimum quality of a wig, no problem will arise because consumers will not get lost when it comes to choosing a medical wig. Taking into account that wigs are covered by health insurance in many European countries, we also aim at health insurance coverage. However, it is a long way to go for health insurance coverage. As for brace for medical treatment, its cost is reimbursed. Thus, we wish to materialize at least JIS mark certification as a previous step for medical expenses deduction.

Health insurance coverage and medical expenses deduction beyond the JIS mark certification

What apparatus, devices or other things are covered by Health insurance?

Artificial limbs which compensate limb function are covered by healthcare insurance. Although I do now know whether they have JIS mark certification, some of them are covered by health insurance. I understand that an artificial eye is to help improve the appearance of people who have lost an eye and that it is covered by health insurance. Even if medical wigs become covered by health insurance, there is no way that all costs are covered by health insurance regardless of 50,000-yen wig or a 500,000-yen wig. I think that the maximum limit for reimbursement will be set per patient. I cannot tell anymore because it is related to the business in the industry. What price will they sell their wig and what quality? These things are what I do not know. It goes without saying that affordable high quality wigs are better for patients. It is important to maintain the performance of wigs by making a final agreement at JIS Committee. JIS specifies "the minimum level of quality which a product should keep" in the first place. It is also important for patients that a product is less costly.

What procedures do you need in order for a product to be subject to medical expenses deduction and health insurance coverage?

For example, we need evidence from the viewpoint of patients. There are some articles which report such research published in other countries, while there is none in Japan. When you submit for application for medical expenses deduction to the Ministry of Health, Labour and Welfare, you need feedback from patients and supporting evidence on why it is required. In addition, the Ministry of Health, Labour and Welfare will barely say "Yes" unless the Japanese Nursing Association and the Japanese Dermatological Association or other academic bodies request for it. As the healthcare cost now places an enormous financial burden on the Japanese Government, you will face high hurdles until it will be covered by health insurance. Several local governments including Yamagata or Kitakami, Iwate support a part of medical expenses. However, this is just aid.

You took leadership in an attempt to achieve something among manufacturers, healthcare professionals and patients. How was it?

I assumed my post as chairperson because I thought it to be a valuable opportunity. As you know, the Committee's ultimate goal is that a product is subject to a tax deduction for medical expenses and health insurance coverage. Materializing JIS mark certification as the previous step is to build a criterion, based on which wig manufacturers are allowed to use the name of medical wig. Also, it gives consumers a feeling of security in using a medical wig. As JIS are national standards, you are not allowed to develop irresponsible standards.

Interviewer/writer: Akiyoshi Sato Photographer: Naoyuki Tamura

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