ジェネリック研究〔総2017；11：067–073説〕〕

地域を支えるフォーミュラリを目指して～医薬品評価方法の確立～
For a Formulary that can Support Communities
─ The Establishment of a Drug Evaluation Method ─
岡﨑 敬之介 * a, b，佐々木 忠徳 a, b
K einosuke Okazaki * a, b, Tadanori Sasaki a, b

昭和大学病院薬局b
昭和大学薬学部病院薬剤学講座aSummar y：Amidst the super-aging society the situation surrounding medical services is becoming increasingly serious,with such concerns as a dramatic increase in the number of elderly patients who need systemic treatment, and a lack ofhealthcare financial resources. What local base hospitals can do to continue providing “quality medical services” despite
such a situation is to create a “formulary.” We believe that the promotion of formulary-based drug therapy can reduce theburden on local hospitals, clinics and pharmacies including family doctors and pharmacists, contributing to the implementation of a community-based care system. Since a selected pharmaceutical agent represents the drug therapy model in aregion, drug evaluation and selection play the most important roles in creating a formulary. Such drug selection requires
the following information:（1）Efficacy and safety information obtained through evidence（e.g. data on therapeutic andadverse effects）,（2）economic efficiency information obtained by assessing the costs of a drug and overall treatment
as well as cost-effectiveness,（3）reasonability information obtained through evaluation of the QOL of the target patientsand the burden on healthcare providers, and（4）others（e.g. information from studies on issues of drug therapy orinsured treatment in consideration of hospitalized care and ambulatory/regional medicine）. Such information should
be examined critically and evaluated appropriately to demonstrate the clinical usefulness of a drug, which is the very
mission of a local base hospital to support communities. Our hospital uses the profiles of a drug and clinical studies
for drug evaluation. With every drug approval, we critically review these profile sheets as the main information source
along with other relevant materials, including interview forms, review reports, RMPs, guidelines, published papers, dataon drug prices, and information on insurance treatments. After a hearing with the representative of a pharmaceuticalcompany to identify issues through questions and answers, we make a pharmaceutical comment. The pharmaceuticalcomment addresses the drug efficacy, safety, economic efficacy, reasonability and other considerations, including theoutline and result of drug evaluation as well as the final decision on drug selection and the conditions for each evaluation
area. At the pharmaceutical affairs committee meeting held once every 2 months, we have discussions with physicians
who have applied for placement as well as committee members engaged in various professions using the pharmaceuticalcomments as reference material for the committee. For the development of a formulary to support communities, we needto establish a drug evaluation method and work on the promotion of further information sharing with local hospitals,
clinics and pharmacies. Herein we outline the evaluation method using a specific drug for osteoporosis as a case example
requiring close cooperation between an acute care hospital and a local medical institution.
Key words：formulary, community inclusive care system, drug evaluation method, drug selection, regional medical care
要旨：超高齢化社会の到来に伴い，全身管理を必要とする高齢患者の激増，医療財源の不足など，医療を取り巻く環境は厳しさを増している．このような環境のもと，地域の基幹病院においては「質の高い医療」を提供し続けるために「フォーミュラリ」を構築し，これに基づいた薬物治療を推進することでかかりつけ医，かかりつけ薬剤師をはじめとする地域の病院や診療所，薬局の負担を減らし，地域包括ケアシステムの実践に貢献できると考えられる．
* 〒 142-8666 東京都品川区旗の台 1-5-8
昭和大学病院薬局医薬品情報管理室
TEL：03-3784-8467 FAX：03-3784-8453
E-mail：k-okazaki@cmed.showa-u.ac.jp

ジェネリック研究 Vol. 11, No. 2（2017）

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