抄録
The objective of this study was to determine whether the quality of pharmaceutical care provided under “iyaku bungyô” (separation of dispensing and prescribing functions) offsets the additional time and expense involved. The subjects of the study were 1, 024 adults living in Tsurumi Ward, Yokohama. We surveyed their willingness to pay (WTP) in the pharmaceutical care setting, and then estimated benefits from the results obtained. Taking the patients' share of the total cost under the medical insurance scheme (co-payment) as the cost, we also performed a cost-benefit analysis (CBA).
The responses of 182 people were used for the analysis of the survey results. The median for WTP was ¥200, and the mean was ¥297 (standard deviation : ¥ 309) and correlations between WTP and age of respondent, existence of a familiar pharmacy, and opinions regarding health care costs were observed. In the cost-benefit analysis which used the median for WTP as a reference, the benefit was greater than the cost for cases when the cost was set as the rate of co-payment of the current consultation fee (30%), but the benefit was less than the cost in cases in which the cost was a greater financial burden to patients than this as a result of iyaku bungyo.
We found that WTP for pharmaceutical care under iyaku bungyo was not greatly influenced by the amount of the respondent's income. The fact that WTP was high for persons having a familiar pharmacy that they regularly visited suggests that the benefit may be higher when people are more satisfied with the pharmaceutical care they receive. Further studies of pharmaceutical care costs using cost-benefit analysis should be made in the future, and situation parameters further refined.
