Japan System Technology Co., Ltd.
Enforced in October 2024 Preliminary impact survey on selection and treatment of original drugs (long-listed products)
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Based on our proprietary medical big data “REZULT,” which is centered on medical receipt data, we conducted a preliminary impact study on the selection and treatment of original drugs (long-term listed products).
From October 2024, patients will be able to purchase a brand-name drug with a generic drug (hereinafter referred to as a “long-term drug”) instead of a generic drug without a special medical reason (if it is deemed medically necessary or if it is difficult to provide a generic drug). A selective treatment system will be introduced in which patients will pay one-fourth of the difference in price between the long-listed drug and the generic drug if they request a long-listed drug.
At our company, we are involved in notification and recommendation projects for proper medication administration, and this time we conducted a survey using medical receipt data regarding the selection and treatment of long-term listed drugs.
[Aggregation conditions]
Survey target: Of the medical receipt data held by our company (approximately 9 million people as of July 2024), we surveyed medical outpatient/dispensing receipt data for the year from January 2023 to December 2023. We investigated the impact if drugs listed on the list of long-term listed drugs published by the Ministry of Health, Labor and Welfare become selected treatments. Generic drugs corresponding to long-listed drugs were assumed to have the same first nine digits of the NHI drug price list drug code.
Reference material: Ministry of Health, Labor and Welfare, Regarding the selection and treatment of original drugs (long-term listed products) with generic drugs
(https://www.mhlw.go.jp/stf/newpage_39830.html)
1. Contents of selection and treatment of long-term listed products The selection and treatment of long-term listed products is
illustrated below. (Figure 1)
If long-listed drugs are continued at the patient’s discretion after the selected treatment, the burden on the patient will increase.
[Image 1: https://prtimes.jp/i/92153/93/resize/d92153-93-f43c54795bf095105645-0.png&s3=92153-93-90f8cd12621467f136ce1e68c927370f-868×776.png ]
[Figure 1] Selection of long-term listed products for treatment 2. Trends in patients who prescribe long-listed products
We investigated the prescription status of long-listed products. Looking at all patients, it was confirmed that nearly half (46.1%) were prescribed some type of long-listed drug. It can be seen that long-listed drugs account for 10.7% of the amount of drugs used, which shows that the scope of the impact of this system change is wide. The drug fee for long-listed drugs is 7.6%, which suggests that the impact on public finances is also large. (Figure 2)
Furthermore, when we looked at the route of administration, we found that injectables accounted for a small proportion, while long-listed topical drugs were used in large numbers. (Figure 3)
Looking at the age group, we found that the usage rate of long-listed drugs was higher among those under 15 years of age. (Figure 4) It is known that the usage rate of generic drugs also tends to be low in this generation. Selected medical treatment fees are also subject to collection for infant medical care, single-parent family medical care, and children’s medical care, so the impact after implementation is likely to be significant.
[Image 2: https://prtimes.jp/i/92153/93/resize/d92153-93-47bd27c56f9d70102dc3-0.png&s3=92153-93-54663d52f095f8e513b5e0f8d29e3c8d-960×500.png ]
[Figure 2] Percentage of patients prescribed long-listed drugs and percentage of long-listed drugs to total drugs
[Image 3: https://prtimes.jp/i/92153/93/resize/d92153-93-6238c38607c08c1a0ed5-0.png&s3=92153-93-408c3c061305e7318a7133c25a4f4130-1280×500.png ]
[Figure 3] Percentage of long-listed products by route of administration
[Image 4: https://prtimes.jp/i/92153/93/resize/d92153-93-34d0f73bb6c14e4a202b-0.png&s3=92153-93-3db7c7779d542982cd66df8142a8bdab-960×500.png ]
[Image 5: https://prtimes.jp/i/92153/93/resize/d92153-93-1ca817cd2b4b3a0ee29f-0.png&s3=92153-93-4b6672f088143b8e946f75faa219b87e-960×500.png ]
[Figure 4] Prescription status of long-term listed products by age group 3. Medical expense burden for selected medical treatment
Regarding the burden of medical costs, we assumed that all patients wanted to continue using the long-listed drug.
If a patient who has been prescribed a long-listed drug wishes to continue using the long-listed drug, the average cost may increase by 608 yen per person per year. (Figure 5)
When we looked at the drugs that were thought to have the greatest impact on patients, we found that the top five drugs could result in an additional cost of more than 100,000 yen per year. The amount of money required for selected medical treatment is also large, suggesting that it may be difficult for patients to continue using long-listed drugs even if they wish to do so. (Figure 6)
Finally, we checked the share rate of the total amount of selected medical expenses for each drug. The top two drugs were Hirudoid (lotion/soft ointment), accounting for 18.5% of the total. There is a drug price difference of about 3 times between long-listed drugs and generic drugs, and the number of prescriptions for these drugs is extremely large, so these drugs may have a large impact on medical finances. (Figure 7)
[Image 6: https://prtimes.jp/i/92153/93/resize/d92153-93-459abc9bf2282a32b91d-0.png&s3=92153-93-a72c1807fbd206c98cef1732de2b86fc-479×500.png ]
[Figure 5] Changes in burden amount for long-term listed products *The patient burden covered by insurance is calculated at 30% (the total may not add up as there are decimal places in the calculation results)
[Image 7: https://prtimes.jp/i/92153/93/resize/d92153-93-ab983ae6a16dd1ed81d1-0.png&s3=92153-93-2f0a1657d690fd323a3454f4a47fe938-1515×209.png ]
[Figure 6] Top 5 drugs that have a large impact on patient burden
[Image 8: https://prtimes.jp/i/92153/93/resize/d92153-93-4cc8234ff62c5c9c7fd7-0.png&s3=92153-93-9fe7ba5e1042bef71126f54c31b668bc-1180×209.png ]
[Figure 7] Share of selected medical expenses Top 5 drugs
Up to this point, we have analyzed the impact of long-listed drugs, focusing on the selection and treatment of long-listed products. Selected medical expenses are, in principle, borne by the patient and are therefore not eligible for subsidies, which may have a direct impact on the patient. For this reason, this system change will likely have a major impact on medical finance, including the impact on the usage rate of generic drugs. We will keep a close eye on the actual impact when the selective medical treatment system comes into effect in October 2024.
As part of our support for data health plan formulation and business implementation, we also provide services ranging from notification to effect analysis regarding proper medication administration (promoting the use of generic drugs, etc.). We also sell ad hoc analyzes and data such as regional difference analysis and patient journeys (*1) using real-world medical data such as anonymized medical claims and medical checkup data for approximately 9 million people. If you have any questions or would like to know more, please feel free to contact us at the address below.
*1 A series of steps from when a patient recognizes a disease, visits a medical institution, and receives treatment.
■Please see below for the medical big data “REZULT” used in this case. https://www.jastlab.jast.jp/rezult_data/
[Inquiries regarding this matter]
Japan System Technology Co., Ltd.
Healthcare Innovation Division
TEL: 03-6718-2785
Mail：rezult@jast.co.jp
URL: https://www.rezult-lp.com/
▼Japan System Technology Co., Ltd. Company Information https://www.jast.jp/ that’s all
[Image 9: https://prtimes.jp/i/92153/93/resize/d92153-93-a08bfe634c7647699a71-0.png&s3=92153-93-03d4e33aa8b75712c80f16d8b609a22e-1000×753.png ]