Useful information

Service to assist people with difficulties taking medication, Part ③ ‘Support for adjustment of medications taken’


Pharmacies are places where you can receive prescription medicines, but there are other services that help patients and their families with issues regarding their medication.
In this column, we would like to inform you about the “medication adjustment support” that you should be aware of if you are worried about an increase in the types of medicines you take on a daily basis, are afraid you may forget to take them, or if you have increased the amount of your medicines while visiting multiple clinics.

Are you concerned about an increase in the number of medicines you take?

The medication adjustment support is a service for polypharmacy measures.
Polypharmacy is often translated as “taking too many medicines” or “taking many different medicines,” but it’s not just about the quantity of medicines; it has a negative impact on health and medical costs by over-prescribing.
For example:
The types of medicines you take every day may have increased, and you may have just forgotten to take some of them; or, You have multiple illnesses and symptoms of concern, so when you visit multiple clinics, each clinic prescribes its own medications, so the number of medications you take has gradually increased.
In such a case, you should know about a service called “medicine adjustment support”.

What is “medicine adjustment support”?

“Medicine adjusting support” means that a pharmacist proposes a reduced dose to the prescribing doctor in writing for patients who are prescribed many types of oral medications, and adjusts the medications.
Basically, it is intended for patients who are prescribed 6 or more types of oral medications to be covered (excluding antipyretic analgesics and other such medications).

Why “polypharmacy” is wrong?

By the way, why is polypharmacy a problem? Medicines are prescribed because of necessity (advantage) of course, but taking an inappropriately large number of medicines can increase the disadvantages.
As the number of types of medicines increases, it can lead to forgetting or mistaking a dose.
Also, taking multiple medications in combination could enhance or cancel out the effects. or side effects may increase. Or, when a patient receives prescriptions from multiple medical institutions, the medicine with the same efficacy may actually be administered in duplicate.
Unnecessary multiple drug administration is also a major problem in terms of healthcare costs for both the patient and society.
There is no clear definition of how many or more drugs are considered “polypharmacy” since whether the number of such medicines is appropriate or not is a case-by-case basis.
However, according to the “Guidelines for Safe Pharmacotherapy for the Elderly” by the Japan Geriatrics Society, the risk of adverse drug incidents was particularly increased with use of six or more drugs in elderly hospitalized patients.

How much does it cost to apply for “medicine adjustment support”?

If you are concerned about the number of medicines that have been increased, please consult a pharmacist at the pharmacy.
By the way, if you consult with a pharmacist who proposes a drug reduction to the prescribing doctor, it will be billed under the category of “medicine adjustment support fee”.
This medication adjustment support fee falls into types “1” and “2”.
● What is “medicine adjustment support fee 1”?
If you have been prescribed 6 or more types of oral medications for 4 weeks or more, and you are having problems because the amount of medication is too great, you can consult the pharmacist, who will reduce the medication by writing to the prescribing doctor. And, if two or more types are actually reduced, it will cost 1,250 yen as a “Drug adjustment support fee 1”.
However, the actual amount of money the patient pays will be only 10 to 30% of it.
● What is the “medical adjustment support fee 2”?
It is intended for patients who are using multiple medical institutions, and are prescribed 6 or more types of oral medications by multiple doctors. After consulting with the pharmacist, the pharmacist will give the prescribing doctor a written reduction of the drug after fully assessing the scope of what kinds of drugs are prescribed, checking for duplicate medications and drugs that are difficult to swallow. The pharmacist will make suggestions to the prescribing doctors.
In this case, it costs 1,100 yen or 900 yen as a “medical adjustment support fee 2” (depending on the pharmacy). The actual amount of money the patient pays for this is 10 to 30% of the fee.

◎ Reference
The Japan Geriatrics Society “Guidelines for Safe Drug Therapy for the Elderly 2015”