Abstract
The increase in national health care costs is a challenge arising from advances in medical care and an aging population. To control these costs, the government initiated the Selective Care System for brand-name drugs (long-listed products) with generic equivalents (GE) in October 2024. Therefore, we conducted a survey to examine changes in the GE usage rate in insurance pharmacies after the implementation of the Selective Care System, as well as the status of explanations of Selective Care by pharmacists. As a result, despite the fact that the total number of prescriptions has increased by approximately 7% year-on-year since October 2024, the GE utilization rate increased to 91.2% on average for all of the stores three months after the start of the Selective Care System, the largest ever. Regional differences in the GE use rate between Saitama and Tokyo showed a slight difference in regard to the process of the increase, but in Saitama, the GE use rate significantly increased year-on-year (p=0.034) from October 2024, when the Selective Care System started, and in Tokyo, the rate significantly increased year-on-year (p<0.001) two months later, thus indicating that the Selective Care System Both showed a significant increase from the previous year within three months of the start of the system. This suggested that the Selective Care System had an impact on GE usage. The GE usage rate may have been influenced not only by patients' concerns about rising out-of-pocket medical expenses due to the start of the system but also by pharmacists explaining the system and GE to approximately 2,500 patients who wanted to select brand-name drugs under the Selective Care System. Considering the constraints on healthcare finances, shifting the healthcare system to using GE, including AG, is desirable once brand name drug patents have expired.
