A Survey of Attitude to Iyaku Bungyo Separation of Dispensing from Medical Practice / 日本農村医学会雑誌

ABSTRACT

Iyaku Bungyo means separation of dispensing from medical practice. Under this system, physicians provide outpatients with prescriptions, if need be, after examinations. The patients visit neighborhood drugstores and produce the prescriptions to pharmacists, who are authorized to accept patients covered by health insurance and to make up prescriptions. The prescribed medicines will be given to the patients in exchange for the payment. The pharmacists will also instruct the customers how to take in the prescribed medicines properly. The system has been so designed as to improve the quality of health care services with the physicians and pharmacists performing their respective roles as the specialists. However, the government office is promoting the Iyaku Bungyo system in favor of the pharmacies outside the hospitals in the name of the containment of medical costs, charging that the medical institutions prescribe and dispense so many kinds and quantities of medicines the patients can hardly take in, simply to make large profits from a comfortable margin between the market price for each pharmaceutical and the price at which it is actually purchased. Ministry of Health, Labor and Welfare officials and insurers have trumpeted the system as if it were an ideal scheme to curb health care costs. In reality, however, medical expenses have been boosted up. It can be taken for granted that the expenditure on national health care is increasing year after year with the population of the elderly on the rise and progress in medical technology. Notwithstanding, it is an important task to hold down increases in the cost of health care with the advent of an era of an aging population.