-Original-

Medical Economic Effect of Pharmaceutical Interventions by Board-Certified Pharmacists in Palliative Pharmacy for Patients with Cancer Using Medical Narcotics in Japan: A Multicenter, Retrospective Study

Takehiro Kawashiri^1,9, Hideki Sugawara^2,9, Katsuya Makihara^3,9, Rintaro Ohno⁴, Yoshihiro Miyamoto⁵, Noriaki Hidaka⁶, Mayako Uchida^7,9 and Hisamitsu Takase^8,9

¹Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
²Department of Pharmacy, Kagoshima University Hospital, Kagoshima, Japan
³Department of Pharmacy, Yodogawa Christian Hospital, Osaka, Japan
⁴Department of Pharmacy, Saiseikai Utsunomiya Hospital, Tochigi, Japan
⁵Department of Pharmacy, Central Japan International Medical Center, Gifu, Japan
⁶Division of Pharmacy, Ehime University Hospital, Ehime, Japan
⁷Department of Education and Research Center for Pharmacy Practice, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyoto, Japan
⁸Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
⁹Clinical Research Committee, Japanese Society for Pharmaceutical Palliative Care and Sciences (JSPPCS), Osaka, Japan

Background: The Japanese Society for Pharmaceutical Palliative Care and Sciences specializes in pharmacology in the field of palliative medicine. More than 700 board-certified pharmacists in palliative pharmacy (BCPPP) are actively involved in palliative pharmacotherapy at various hospitals and pharmacies. The purpose of this study was to determine the economic effect of pharmaceutical interventions by BCPPPs.
Methods: This multicenter retrospective study included 27 medical centers and analyzed the medical economic effect of interventions by BCPPPs (17 pharmacists) and non-BCPPPs (24 pharmacists) on patients using medical narcotics for cancer pain in September 2021.
Results: The percentage of patients who received a pharmaceutical intervention and whose drug costs were reduced by pharmacist intervention was significantly higher in the BCPPP group than in the non-BCPPP group. Although there was no significant difference between the two groups in drug cost reduction per patient per month (BCPPP group: $0.89 [−$64.91 to $106.76] vs. non-BCPPP group $0.00 [−$1,828.95 to $25.82]; P = 0.730), the medical economic benefit of pharmacist intervention in avoiding or reducing adverse drug reactions was higher in the BCPPP group ($103.18 [$0.00 to $628.03]) than in the non-BCPPP group ($0.00 [$0.00 to $628.03]) (P = 0.070). The total medical economic benefit-the sum of these-was significantly higher in the BCPPP group ($88.82 [−$14.62 to $705.37]) than in the non-BCPPP group ($0.66 [−$1,200.93 to $269.61]) (P = 0.006).
Conclusion: Pharmacological intervention for patients with cancer using medical narcotics may have a greater medical economic benefit when managed by BCPPPs than by non-certified pharmacists in Japan.

J Nippon Med Sch 2024; 91: 59-65

Keywords
medical economic effect, palliative pharmacy, pharmaceutical interventions, opioids

Correspondence to
Takehiro Kawashiri, Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
kawashiri.takehiro.650@m.kyushu-u.ac.jp

Received, February 14, 2023
Accepted, June 23, 2023