As with any data of this nature, there is some uncertainty in the results and further research is warranted. However, based on the results of this pharmacoeconomic evaluation, varenicline, the first non-nicotine, oral treatment developed for smoking cessation, appears to be cost effective and may contribute to future medical cost savings in Japan.

More prescription drugs are dispensed by pharmacists rather than doctors in response to government healthcare reform. However, the results of our preliminary survey suggested a hypothesis that patients were not always satisˆed with explanations provided by pharmacists upon dispensing, and therefore patient satisfaction might be enhanced if pharmacists spent more time on consultation services. The survey was conducted in 1,800 people. 321 people (17.8％) answered that pharmacist explanations were not su‹cient or that they expected further consultation with pharmacists. The most common reason why they did not ask for consultation was that other patients were waiting (41.7％). If up to 30-minute consultation service was available at a pharmacy where patient privacy was ensured, 898 people (49.9％) answered that they wanted to use the service. The average willingness-to-pay (WTP) for the service was 338 yen and the mean WTP was 400 yen. When those who answered 0 yen were excluded, the average was 386 yen and the mean was 400 yen. The online survey revealed that some patients were not satisˆed with pharmacist explanations upon dispensing, and that there was a need for consultation services at pharmacies. Many of the reasons why patients did not ask for consultation although they wanted to were attributable to pharmacies, and the survey results suggested a need for improvement in their services. In view of the WTP for the service, it is considered worthwhile to discuss the introduction of such a system for consultation services into dispensing fee.

As it is an urgent issue to contain increasing healthcare expenditures, unlimited reimbursement of pharmaceuticals continues to be controversial. The objective of this study is to identify acceptable incremental cost eŠectiveness ratios between new and conventional therapies. Clinical study data forˆve statin therapies were used to indicate treatment eŠec-tiveness and incremental costs were indicated by price premiums at price listing. The incremental cost eŠectiveness ratios to pravastatin were 0 yen/patient with response, 1,475.1 yen/patient with response, 3,033.3 yen/patient with response, and 3,032.4 yen/patient with response. By conducting further analyses in various pharmaceuticals and categorizing acceptable incremental cost eŠectiveness ratios based on the disease severity and expected level of improvement in disease condition, drug prices that re‰ect the value of new pharmaceuticals and that are reasonable to be reimbursed can be suggested.

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