2020 Volume 7 Issue 1 Pages 33-41
As part of the Japanese Government’s 2018 revision of medication-dispensing fees, a new “medication adjustment subsidy” was established to evaluate pharmacists’ execution of the polypharmacy reduction policy. We calculated the subsidy received by the authors’ pharmacy for 123 of its patients and analyzed patients’ characteristics, reasons for discontinuation of medications, what these medications were taken for, and pharmacists’ years of experience. A Cost-effectiveness was performed for the additional income. The number of drugs per capita decreased from 9.0 to 6.0. We found that 274 (87.3%) medications were discontinued based on a pharmacist’s recommendation. Most of these were gastrointestinal medications and antipyretic analgesics being taken together. Although the number of medications consumed by these patients peaked between ages 80 and 84 at 10.7, there was no major age-related difference in the number of discontinued medications. Of these, 190 (69.3%) were being taken for no reason. The subsidy for the patients was received in 133 payments, amounting to ¥166,250. During the 28-day calculation period, the cost of patients’ prescriptions decreased by ¥461,680. No significant relationship was found between pharmacists’ experience and the results. The study suggests creating an environment wherein pharmacists collaborate with physicians and other healthcare providers for each patient based on a routine that involves following-up with patients after they begin taking a medication, assessing from a pharmacological perspective, and providing feedback to the patient’s physician to reduce the problem of polypharmacy by reducing the number of medications patients take and help lower medical costs.
