Wakako Naoya, Yamaura Katsunori
Faculty of Pharmacy, Tokyo University of Pharmacy and Life Sciences.
Fort Royal Pharmacy Oak Bay.
Yakugaku Zasshi. 2020;140(11):1365-1372. doi: 10.1248/yakushi.20-00105.
Japan's health care system can be regarded as one of the best worldwide, provided it remains sustainable. It has relatively low costs, short wait times, low disease incidence, and high life expectancy. However, universal coverage in Japan faces financial challenges due to the country's rapidly aging population. Canada is another of the few developed countries that have universal health coverage. In contrast to Japan, Canada's health care spending is still sustainable according to recent studies. Effective cost control by payers has played a major role, with providers being steered toward evidence-based and cost-effective drug therapies. Furthermore, expanded pharmacy services have been important in suppressing spending on prescription drugs and minor health care services such as vaccination, government-funded smoking cessation, and medication review programs. This article outlines the services provided by Canadian pharmacists with expanded scope of practice. The pharmaceutical profession and its advocacy body in Canada have not only played a role in regulatory changes, but also put in place technological infrastructure called PharmaNet and contributed to appropriate prescribing. Given the current economic situation and demographic trends in Japan, more options should be explored in order to maintain universal health coverage by meeting the funding gap. Utilizing community pharmacies and pharmacists is proposed as one option.
日本的医疗保健系统倘若能保持可持续性，可被视为全球最佳的医疗保健系统之一。它成本相对较低、等待时间短、疾病发病率低且预期寿命长。然而，由于日本人口迅速老龄化，全民医保面临财政挑战。加拿大是少数几个拥有全民医保的发达国家之一。与日本不同，根据最近的研究，加拿大的医疗保健支出仍具可持续性。支付方有效的成本控制发挥了主要作用，促使医疗服务提供者采用循证且具成本效益的药物疗法。此外，扩大药房服务对于抑制处方药以及诸如疫苗接种、政府资助的戒烟和药物审查项目等小额医疗保健服务的支出至关重要。本文概述了加拿大执业范围扩大的药剂师所提供的服务。加拿大的制药行业及其倡导机构不仅在监管变革中发挥了作用，还建立了名为PharmaNet的技术基础设施，并推动了合理用药。鉴于日本当前的经济形势和人口趋势，应探索更多选项，以通过填补资金缺口来维持全民医保覆盖范围。提议利用社区药房和药剂师作为一种选择。
