Prescription, Dispensation, and Generic Medicine Replacement Ratios: Influence on Japanese Medicine Costs

This study examined the effect of the separation of dispensing and prescribingmedicines between pharmacies and clinics (the separation system) and thegeneric medicine replacement ratio on the cost of various medicines in Japaneseprefectures. We obtained publiclyavailable data from electronic databases and official web pages of the Japanesegovernment and nonprofit public service corporations. For Japanese medicalinstitutions, participation in the separation system is optional. Consequently,the expansion rate of the separation system for each administrative district ishighly variable. In our multiple regression analysis, various daily medicineswere the objective variable and the expansion rate of the separation system andgeneric medicine replacement ratio were the explanatory variables. The expansion rate of the separation systemshowed a significant negative partial correlation with the daily costs oftotal, internal, single use, and injection medicines as well as medical devices. Moreover,the rate of replacing brand name medicines with generic medicines showed asignificant negative partial correlation with the daily costs of total,internal, and single use medicines. However, the two factors had no significantpartial correlation with external medicine costs. Thus, the separation system was as effective in reducing medicine costs asthe use of generic medicines, except in the case of external medicines. Despitethe latter case, the separation system should be expanded, especially in Asiancountries in which the system is underdeveloped, because the system cancontribute to reduce the total costs of prescriptions.Keywords: generic medicine replacement, economicmotive, multiple regression, separation system