Abstract
Against the backdrop of increasing medical costs associated with factors such as the aging population and sophisticated medical technology, interest in medical economics is expanding. In 2019, Japan’s total medical expenses exceeded 44 trillion yen, with drug costs accounting for approximately 20%. Various factors are responsible for the increase in medical expenses, but medical expenses for lifestyle-related diseases are particularly problematic. Therefore, in this study, we investigated the status of metformin use, a drug frequently prescribed as a therapeutic agent for type 2 diabetes, and the current status of its adoption in clinical settings (hospitals). Results showed that use of metformin, based on NDB open data, has been increasing year by year since 2015, and more than 2.2 billion tablets were used in 2020. The adoption of metformin in clinical settings (hospitals) was observed in all facilities surveyed. However, more than 80% of the facilities used only 250 mg/tablet as the standard. Therefore, in cases where the single dose was 500 mg, two 250 mg tablets were dispensed. Metformin is a relatively inexpensive drug; as of April 2022, the price for250 mg/tablet and 500 mg/tablet generic drugs was the same (10.10 yen). Thus, if the single dose is 500 mg, the drug cost is twice as much when dispensed as two 250 mg tablets, compared to that when dispensing one500 mg tablet. Regardless of whether it is adopted in the hospital, in the case of generic drug prescriptions, itis possible to change to the appropriate tablet standard at the discretion of the pharmacist at the insurance dispensing pharmacy, depending on the notation on the outpatient’s prescription. Therefore, the effect of drug dissolution behavior based on single tablets (one 500 mg/tablet) and multiple tablets (two 250 mg/tablet)was evaluated and found to be equivalent, suggesting the possibility of drug cost savings at the pharmacist’s discretion even while continuing current treatments.
