Objective: Crimes related to falsified medicines for medical use are of international concern and becoming increasingly sophisticated. Therefore, in this study, we investigated information on education and training/enlightenment activities on falsified medicines worldwide that are open to the public on the Internet to contribute to medical/pharmaceutical professionals’ and consumers’ education regarding falsified medicines in Japan.Methods: In April 2023, we searched the information written in English and Japanese on education and training/enlightenment activities on falsified medicines using the Internet.Results: We surveyed several countries and obtained important findings. In particular, the World Medical Association (WMA), the International Pharmaceutical Federation (FIP), and the World Health Professions Alliance (WHPA) released programs for healthcare professionals. The US news programs, the US Department of Justice, and the Council of Europe released consumer warning videos. Japan issued the “Guidelines for Good Distribution Practice (GDP)” to the pharmaceutical distribution industry in 2018. Additionally, US and UK medicine regulators and the International Criminal Police Organization (ICPO) offered programs for professionals such as police and customs officers, and public prosecutors.Conclusion: These programs contain useful information not only for medical/pharmaceutical professionals in Japan but also for consumers. However, many are provided by foreign governments or international organizations, while few are from Japan. Therefore, to prevent the distribution of falsified medicine in Japan, educational institutions must further strengthen education and training/enlightenment activities and develop and publish educational tools for falsified medicines.

The import of medicines for personal use by physicians for aesthetic-related medical treatments in Japan is limited to cases such as a medical emergency and when substitutes are unavailable in the country. However, the real reasons why doctors import these products and their safety have not been investigated. Therefore, to contribute to future countermeasures, we investigated the circumstances for personal import of these medicines. We found that 60 of 177 (33.9%) physicians in the cosmetic surgery, plastic surgery, and dermatology departments had experience of importing medicines. Although only medically urgent medicines can be imported, 11.7% of physicians who imported medicines cited price differences between Japan and other countries as the reason for importing. Botulinum toxin injections (25.0%) were the most commonly imported medicines. Furthermore, 11 physicians (18.3%) responded that there was some defect in the products. This proportion was significantly higher among physicians who experienced a product efficacy or safety issue (68.8%) than among those who had never experienced it (0.0%) (P<0.001). This survey revealed that the import of aesthetic-related medicines that are not suitable for personal import is rampant. In addition, there could be an association between the defects of these products and their efficacy/safety. Therefore, to prevent health damage caused by these medicines, it is important to strengthen the regulatory system for collecting and providing information to ensure thorough confirmation (regarding specifications and package insert) at the time of delivery and use in patients and to tighten administrative checks about reasons for import.

Owing to the fear of worsening their relationship with physicians, several pharmacists hesitate to contact physicians regarding prescription-related questions. We investigated the personal factors of pharmacists contributing to their hesitation to contact physicians regarding prescription-related questions. We analyzed the responses of 213 pharmacy pharmacists. A comparison of the degree of hesitation to contact physicians regarding prescription-related questions revealed that the most hesitant questions were pertaining to “the same prescription content from before”; insurance questions (3.37) were higher than medical questions (3.20) (P＝0.006). The multiple regression analysis results revealed that “pharmacy work is busy and there is no time” was influenced by regular employees (medical (β＝−0.181, P＝0.030) and insurance (β＝−0.257, P＝0.002)). “A co-pharmacist said no questions needed” was influenced by the sex of pharmacists (medical (β＝0.194, P＝0.011) and insurance (β＝0.177, P＝0.020)). Overall, type of questions (medical or insurance) and individual backgrounds (prescription issuing medical institution, pharmacy scale, location, age, sex, employment type, years of service, current management pharmacist, and hospital work experience) have a complex effect on the pharmacists’ psychology. To facilitate pharmacists to contact physicians regarding prescription-related questions, physicians and pharmacists should share information and communicate on a daily basis, such as actively participate in joint training programs. It is also important to create an environment where regular employees and female pharmacists can work comfortably. The smooth resolution of prescription-related questions by relieving the psychological pressure of pharmacists will improve patient safety.