Objective: To clarify the actual situation about awareness of DI (the Drug Information in-charge) or information shared with the hospital including prescribing physician regarding the generics, which have added with other dosage innovators don’t have.
Methods: We did the questionnaire and analyzed awareness of DI, route of access to information, situation of transmission for the prescribing physician, and prescription regarding generics added with other dosage (Clopidogrel 50 mg, Quetiapine 12.5 mg, 50 mg, and Tacrolimus 1.5 mg, 3 mg).
Results: There were many cases that DI obtained the information regarding generics added with other dosage from MRs, magazine or website Web.  On the other hand, in case that conveys information about generics added with other dosage to the prescribing physician wasn’t so many.  And there were various reasons why the Drug Information in-charge didn’t inform to the prescribing physician.
Conclusion: Analysis of the valid responses was that more than two-thirds of DI recognized about generics added with other dosage of Clopidogrel and Quetiapine.  But share of recognition of DI was below 30% in case of Tacrolimus.  Also, share of transfer to the prescribing physician was about 15% in any case.  Main source of information about generics added with other dosage for DI was from MRs, magazine or website.  As the number of the companies which sell generics added with other dosage of Tacrolimus is few, we assumed that most of DI didn’t recognize it.  In addition, there were many comments which were judged that it isn’t necessary to transmit to the prescribing physician information generics added with other dosage in case of Clopidogrel and Quetiapine in the questionnaire.  On the other hand, though the number of sample was small compare to the case of Clopidogrel and Quetiapine, there was no comment that generics added with other dosage of Tacrolimus isn’t necessary.

From December 1997 to February 1998, prescriptions for 875 patients with colds at the three institutions listed were investigated. The prescriptions were divided into three groups according to the nature of the drugs; modern drugs, Kampo medicine and combined use of modern and Kampo medicine. Mean age, the number of prescribed drugs and the days of prescription were checked and the medicinal expenses were calculated. When using only modern drugs, daily expenses were 203.8yen in average. On the other hand, using only Kampo medicine they were 119.6yen. When using combination of modern and Kampo medicine, the expenses reached to 215.9yen. These results indicated that Kampo medicine was the most economical, because using only Kampo medicine made the expenses approximately 60% less than those using only modern drugs. Thus, at least 41.5 billion yen could be saved in 1998 calculating from the market share of the national medical supplies in each therapeutic category. In conclusion, treatment of colds with only Kampo medicine was considered to be the most cost-efficient way.

All prescriptions containing Dai-kenchu-to (DKT, Da-Jian-Zhong-Tang), one of the most commonly prescribed Kampo medicines (Sino-Japanese traditional herbal medicines) in Japan, that had been issued during a six-month period from September 1999 to February 2000 at Kitasato University Hospital, were analyzed. The DKT used at this hospital was in the form of ethical extract granules (Tsumura, Tokyo), and it was mainly prescribed to patients who were treated in the Departments of Gynecology and Surgery and who had undergone surgery. In order to clarify problems in the administration of DKT granules to post-operative patients, a questionnaire was distributed to nurses working in the wards of eight large hospitals (over 470 beds each). More than 80% of the nurses reported that they had observed problems with the taste and dosage of DKT administered to their patients. Hard granules do not readily dissolve in water, and the nurses observed difficulty in deglutition upon oral administration of DKT, and tube obstruction in patients who were administrated DKT through a gastric tube. These difficulties in the administration of DKT are thought to increase the workload of the care staff, and the development of a new route of administration of DKT, for example, a decocted solution packed into a stick, is expected.