Objective : Injectable drugs usually include several products of different dosage and price. It is, therefore, difficult for pharmacists and medical staff to select the optimal combination of the products, which provides product selection and sufficient drug amounts prescribed while minimizing the price. We developed a support program for optimizing by using a processing software, NaU DSP®.
Methods : Our program has a simple function to calculate and find the optimal combinations among the potential alternatives. We applied this program to analyze RANDA®, a cisplatin preparation, which has three products containing 10mg, 25mg and 50mg at a price of ¥4, 555, ¥11, 000 and ¥19, 860, respectively. Seven hundred forty-two prescriptions including RANDA® were investigated.
Results : In seventy-eight prescriptions (11%), there was a reduction in the total price of the product combinations between the selection aided with and without the program.
Conclusion : By using the optimization program, pharmaceutical costs can be curtailed more effectively than by arbitrary selection by medical staff.

Objective: To examine the effectiveness of progestin re-treatment for recurrent endometrial intraepithelial neoplasia (EIN), atypical endometrial hyperplasia (AH) and endometrial cancer (EC) following initial fertility-sparing treatment. Methods: A comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Endometrial Cancer Committee. Multiple search engines, including PubMed/MEDLINE and the Cochrane Database, were searched in December 2021 using the keywords “Endometrial neoplasms,” “Endometrial hyperplasia,” “Endometrial intraepithelial neoplasia,” “Fertility preservation,” “Progestins,” AND “Recurrence.” Cases describing progestin re-treatment for recurrent EIN, AH and EC were compared with cases that underwent conventional hysterectomy. The primary outcomes were survival and disease recurrence, and the secondary outcome was pregnancy. Results: After screening 238 studies, 32 with results for recurrent treatment were identified. These studies included 365 patients (270 received progestin re-treatment and 95 underwent hysterectomy). Most progestin re-treatment involved medroxyprogesterone acetate or megestrol acetate (94.5%). Complete remission (CR) following progestin re-treatment was achieved in 219 (81.1%) cases, with 3-, 6- and 9-month cumulative CR rates of 22.8%, 51.7% and 82.6%, respectively. Progestin re-treatment was associated with higher risk of disease recurrence than conventional hysterectomy was (odds ratio [OR]=6.78; 95% confidence interval [CI]=1.99–23.10), and one patient (0.4%) died of disease. Fifty-one (14.0%) women became pregnant after recurrence, and progestin re-treatment demonstrated a possibility of pregnancy (OR=2.48; 95% CI=0.94–6.58). Conclusion This meta-analysis suggests that repeat progestin therapy is an effective option for women with recurrent EIN, AH and EC, who wish to retain their fertility.