2019 Volume 9 Issue 3 Pages 141-150
This study investigated the prescriptions in which generic substitutions were not allowed by prescribers. Among 945,668 prescriptions received by 2,667 community pharmacies which belonged to Nippon Pharmacy Association during any one week from July 2018 to August 2018, there were 103,378 prescriptions (10.93%) in which generic substitutions were not allowed. Regarding “the percentage of prescriptions in which generic substitutions were not allowed” (hereinafter “the value” ) in each responded pharmacy, “≦5% of all the prescriptions” was most popular in 46.38% of the responded pharmacies, followed by “0% of all the prescriptions” in 17.51% of them. Though the average of “the values” among the responded pharmacies was 10.22%, the median value was 2.74%. Thus, there was a big difference in “the values” among the responded pharmacies because “the value” was 2-3% in over the half of the responded pharmacies, whereas, there were some pharmacies where “the value” was large. In Kyusyu/Okinawa region, the median value was 0.70%, the smallest among all the regions, and “the value” was ≦5% in over 75% of the responded pharmacies. In Hokkaido region, the average was 12.9%, the largest among all the regions, and “the value” was ≦5% in only 61.5% of the responded pharmacies. The average values were different among regions and were over 10% in Hokkaido, Chubu, Kinki and Shikoku regions. Regarding the reasons for not performing generic substitutions for the prescriptions in which generic substitutions were allowed, “patients' preferences” are most indicated by 94.94% of the responded pharmacies. As the other reasons described by the responded pharmacies, “prescribers' verbal instructions” was indicated most. Whereas “the value” was very small among over the half of the pharmacies, the value was large in some of the pharmacies. Therefore, the policy focusing these pharmacies in which “the value” was large. Further study is needed to expand the survey on the pharmacies with variety of characteristics.
