This study aimed to evaluate the effects on the medical economy of the use of tracing reports by pharmacybased pharmacists for pharmaceutical interventions, including to reduce leftover medicines. These effects were estimated by analyzing 267 tracing reports issued by pharmacy pharmacists over a period of 1 year, 2020-2021. We estimate that these interventions created cost savings of USD108170.02/year (USD104800 via pharmaceutical interventions, USD3370.02 via interventions to reduce leftover medicines). The cost savings from pharmaceutical interventions prompted by patient follow-up was estimated to be USD47650. The medical economic effect per tracing report was estimated to be USD392.51 from pharmaceutical interventions, USD12.62 from reducing leftover medicines, and USD445.33 from pharmaceutical intervention prompted by patient follow-up. Overall, therefore, pharmaceutical interventions by pharmacy pharmacists using tracing reports, including those designed to reduce leftover medicines, may benefit the medical economy.
Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine malignancy of the skin. We report a case of MCC of the lower lip. An 85-year-old woman was referred to our hospital because of a tumor in her lower lip. An extraoral examination revealed a palpable soft tumor measuring 17 × 11mm. A malignant tumor was suspected, and a FDG-PET/CT was performed. Accumulation was observed in the lower lip, the first spinous process, the right side of the second vertebral body, the left seventh rib, and the right pubis. The lip was resected first, because it was considered to be a bone metastasis of non-Hodgkin's lymphoma, the treatment of which had been discontinued in the past. A pubic biopsy was performed after surgery and MCC with multiple bone metastases was diagnosed. The painful pubis and ischium were irradiated (30Gy/10fr) , and Avelumab and Denosumab administered. However, brain metastasis and irAE enteritis were observed, and the patient died of this disease one year and eight months after the initial diagnosis.
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