2010 Volume 22 Issue 1 Pages 31-44
Under the health guidance program implemented in April 2008, physicians should consider starting drug treatment only when health guidance for diet, exercise and smoking cessation do not show sufficient effects on their patients. Making such drug available over the counter for consumers, however, may actually contribute to the reduction of healthcare costs. We estimated the reduction in healthcare costs obtained through self-medication of a hypothetical OTC antihyperlipidemic drug. The drug will be equivalent to pravastatin 10 mg and, and it will be offered to patients for whom hyperlipidemia control was judged to be necessary at a health examination.
Patients aged 40 who use the OTC antihyperlipidemic drug would live 0.17 years longer than those who do not use the drug, and would achieve an overall reduction in healthcare costs of 436,000 yen. The savings will translate to the reduction of 137.7 billion yen in national healthcare expenditures over the next 10 years and to 605.6 billion yen over the next 20 years. Since these savings are achieved by shifting the costs of drugs from insurers to consumers, ultimately leading to increases in individual patient’s financial burden. An additional analysis was therefore performed to estimate the increase in the insurer’s burden that could be used to reduce a part of the individual patient payments for the OTC drug. As a result, the healthcare cost reduction is offset when insurance payers bear 35,432 yen. This annual burden would bring about a patient payment reduction of approximately 79% when the price of an over-the-counter antihyperlipidemic drug is equivalent to that of Mevalotin （2008 revision price）.
