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关于社区药剂师对就医生开具的处方提出药学问题的认知的医学经济学研究

[Medical economics research on awareness of community pharmacists about raising pharmaceutical questions regarding prescriptions issued by physicians].

作者信息

Shikamura Yoshiaki, Oyama Akiko, Takahashi Junichi, Akagi Yuuki, Negishi Kenichi, Ijyuin Kazushige, Kamimura Naoki, Aoyama Takao

机构信息

Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan.

出版信息

Yakugaku Zasshi. 2012;132(6):753-61. doi: 10.1248/yakushi.132.753.

Abstract

This study examined the impact of pharmaceutical inquiries regarding prescriptions on drug costs by surveying the actual condition of inquiries at 13 pharmacies. The study also investigated the significance of inquiries from a medical economics perspective by calculating the medical cost savings realized by preventing adverse drug reactions (ADRs). As a result, the total change in drug costs for the 13 pharmacies after pharmaceutical inquiries represented an increase of ¥9,018/month. However, upon recalculating the cost of drugs by assuming that those with an "Incomplete entry in the prescription (compared with previous prescription, etc.)" should in fact have been prescribed, and excluding them, the total drug costs for the 13 pharmacies is decreased to ¥154,743/month, translating to a cost-savings of ¥7.2/prescription. The study then undertook a comprehensive assessment based on the Diagnosis Procedure Combination (DPC) system to determine the total medical cost-savings for 5 patients in whom ADRs could have occurred if the prescriptions had not been modified as a result of pharmaceutical inquiries. The obtained figure of ¥1,188,830 suggests that pharmaceutical inquiries contribute to reduced medical costs. The findings of this study indicate that pharmaceutical inquiries regarding prescriptions by staff pharmacists not only ensure the proper delivery of drug therapy to patients, but are also effective from a medical economics perspective.

摘要

本研究通过调查13家药店的实际问询情况,考察了药品处方问询对药品成本的影响。该研究还从医学经济学角度,通过计算预防药物不良反应(ADR)所实现的医疗成本节约,来调查问询的意义。结果显示,13家药店在进行药品问询后的药品成本总变化为每月增加9018日元。然而,假设那些“处方录入不完整(与之前的处方等相比)”的药品实际上本应被开具,并将其排除后重新计算药品成本,13家药店的药品总成本降至每月154743日元,即每张处方节省成本7.2日元。该研究随后基于诊断程序组合(DPC)系统进行了全面评估,以确定如果因药品问询而未修改处方,5名可能发生ADR的患者的医疗成本总节约情况。所得到的1188830日元这一数字表明,药品问询有助于降低医疗成本。本研究结果表明,药剂师对处方进行问询不仅能确保向患者正确提供药物治疗,而且从医学经济学角度来看也是有效的。

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