Painful diabetic neuropathy (PDN), which occurs in 30% of patients with diabetes, reduces quality-of-life (QOL), but active intervention is accompanied with financial challenges and requires more cost-effective drug selection for intervention. The purpose of this scoping review is to examine the results and issues on the cost-effectiveness analysis (CEA) of PDN treatment in other countries and to discuss ways to proceed with CEA in Japan. MEDLINE and Embase were used for the search, and 10 studies were selected from 829 studies from 2005 to 2020 for examination. The examination clarified that the model structure and the setting of utility values differed depending on the characteristics of drugs focused on in the CEA of PDN treatment (e.g., definition of pain relief, adverse events, etc.), and the results differ as well. CEA based on pain intensity showed the superiority of pregabalin, but did not reflect the impact of factors other than pain on QOL or the diversity of PDN treatment over the long term. For future CEAs, it is desirable to ascertain the utility values and QOL associated with intervention effects and adverse events by conducting clinical trials for the analysis, and to expand the grasp of actual conditions in daily practice and ensure transparency in this process.

Objective: Maintaining and improving medication adherence are vital for the treatment of type 2 diabetes. Centralized administration of medication by a family pharmacist is expected to improve medication adherence, even during infectious disease epidemics. This study aimed to determine the effects of the family pharmacist system on medication adherence in patients with type 2 diabetes before and after the COVID-19 epidemic in Japan. Methods: Using anonymously processed receipt data from 628 insurance pharmacies operated by our group, three levels of medication persistence (gap, interruption, persistence) and medication possession (poor, good, excessive) were evaluated in patients receiving dipeptidyl peptidase (DPP)-4 inhibitors and metformin before the COVID-19 epidemic (pre-epidemic), and during the first and second years of the epidemic (epidemic years 1 and 2, respectively) The results were compared between the family pharmacist and non-family pharmacist groups. Results: The odds ratios for the proportion of patients with good medication adherence (medication persistence: persistence, medication possession: good) in the family pharmacist group relative to that in the non-family pharmacist group were significant in the pre-epidemic period (1.612) but not in epidemic years 1 (1.353) or 2 (1.304). Conclusion: Our results suggest that the family pharmacist system improves adherence to DPP-4 inhibitors and metformin; however, its effectiveness decreased during the COVID-19 epidemic. Therefore, to improve medication adherence even during infectious disease epidemics, we believe it is important to create an environment in which family pharmacists can perform their roles not only in person but also remotely.