
History of the establishment and training of the oncology pharmacist in Japan, and their rolein clinical practice*
Masami Kawahara *, Ph.D.

Department of Clinical Pharmacy and Sciences, School of Pharmacy, Aichi-Gakuin University

Summary
Malignant tumors are the leading cause of death in Japan, and various policies are being implemented, including Cancer Control Act
enacted in 2006. Since the 1990s, the work of pharmacists in wards has been highly evaluated and their work have expanded. In theUnited States, the board-certified oncology pharmacist (BCOP) authorization was started in 1998 by the Board of Pharmacy Specialties
established in 1976 as an autonomous division of the American Pharmacists Association. The BCOPs improve patient care and play
an important role in multidisciplinary healthcare team. The Japanese Society of Hospital Pharmacists started the system for theoncology pharmacist in 2006, based on the US system, and a three-month training program was launched. It was consisted from lecture
training, practical training, and clinical research. This three-month training program has resulted in an increase in the number ofoncology pharmacists. Many oncology pharmacists have begun the clinical researches, and evidences are emerging. In 2009, theoncology pharmacist system was transferred to the Japanese Society of Pharmaceutical Health Care and Sciences, and became the firstts are wide-ranging,including regimen management, participation in and support for anti-tumor drug prescription design, guidance about the side effect topatients, supportive care, and conducting outpatient preliminary consultations. The presence of oncology pharmacist is essential for
implementing cancer chemotherapy, and it is necessary to train more certified pharmacists.
Keywords: oncology pharmacist, cancer chemotherapy, cancer control act, clinical research*Corresponding author:
Masami Kawahara *, Ph.D.
Tel: +81-52-757-6767, Fax: +81-52-757-6799
e-mail address:m-kawa@dpc.agu.ac.jp

1984

1.

1993

10
1981
2022

1981

124.6%1)

1994 2003
101

2004 2013

310

2005
2005
2006
20072)

2014

10

310

2007

610
Table 1
20043)

2000
3(Fig. 1)

2005

Table 1. History of Cancer Prevention Act

2

Fig. 1 Overview of the Basic Plan to Promote Cancer Control Programs
Cited from White Papers & Reports, Annual Health, Labour and Welfare Report 2009-2010, 2. Health and Medical Services, No.50.
https://www.mhlw.go.jp/english/wp/wp-hw4/dl/health_and_medical_services/P74.pdf, (accessed Oct. 23, 2023).

2.

Table 2.

1976
(APhAAmerican Pharmacists

Association)(BPS:Board of Pharmaceutical Specialties)

1990
1998
14

Number of Active Certifications Issued by the Board ofPharmacy Specialties

Table 24,5)

320056)

ACCP:

American Clinical College of Pharmacy

2006

55,0007)

2023

8145)

57,629
Table 21)

50%
1998

2)

2005
2022

12500
4,1213)
4)

3.

5)

30

6)

1989
19948)

20PharmD
9)(Doctor of Pharmacy)
PGY1 (Post Graduate Year 1)

PGY2 (Post

Graduate Year 2)

BPS

2

7

Table 3
Table 3. Application requirement for oncology pharmacist in Japan and US41998

4198010)

1998

1

1100

AphA

BPS

1981
TDM: Therapeutic Drug Monitoring
TDM

PK/PD

4
1990

200

1994
600

480x2

350x4
2000

1995

11)

1
Table 3)
10)

310

1998
2006
1,40010)

4.
2000
2001

3NST

3

2004
Table 3

51

3
8
20300
2005
2006

1

121227

2

1
2006

33
41

29

12

1

329

12006

29

1

2006
Fig.2
2006

91

1
332006

91

3

3

22
Fig. 2 Changes in the number of oncology-related papers in the totalnumber of papers in the two journals for hospital pharmacists
Open circles represent the total number of accepted papers, closed
circles represent the number of oncology-related papaers, closed
diamonds with dotted lines represent the percentage of oncology-

GVHD: Graft Versus

related papers in the total papers. (A) Japanese Journal of

Host Disease

Pharmaceutical Health Care and Sciences, (B) Journal of JapaneseSociety of Hospital Pharmacists. *: the data for 2009 is 6 months.

NST5.

2006
2006

6182007

20115512)

2006
0201004
2181
1212009
12008
11BPS2023813)

6.
2010

7.

2002
2023
559
27

2

716

533Fig. 3 Increasing of Board certified Oncology Pharmacists of5Japanese Society of Pharmaceutical Health Care and Sciences (BCOPJSPHCS)
Closed bars represent the total number, gray bars represent the5renewal number and open bars represent the newly approved numberfor BCOP-JSPHCS, respectively.

14)

8.
2

2012

12450

40
753

2012
:24929009

125

1250
2012
Fig.4
5233

69Fig.32023

3202278615)

8588%

4212%

52012201917

3. The pharmacist shall verify patient registration and7

informed consent prior to dispensing the treatment

7
2011
2021

Fig. 4 Survey results for participants
A questionnaire survey was conducted among 25 participants of thefirst case review meeting. Submitting 50 case reports was the mostdifficult task, and all participants answered that they would like toparticipate in the next time.

9.
2011
MSKCC (Memorial Sloan Kettering Cancer Center)

200

Lucarelli C.D

Oncology Pharmacist Responsibilities
1. Interpretation of Physician Orders--All orders arechecked with the patient s medication profile andprotocol (when appropriate) for the agent, dose,frequency and schedule
2. The pharmacist shall check for the accuracy ofdosage; observance of attenuation schedules; routeand mode of administration; ensures that, whennecessary, pre and post therapy medication isgiven; checks the pretreatment lab values, signs theorder and initials appropriate lab values

9FEC (5FU + Epirubicin + Cyclophosphamide)
23EC

FEC

DOC (DOC: docetaxel)
ECFEC

Grade 1DOC
Grade 257%16)

218)

4510.
4N-3319)117)

1624016 mg/day

6 mg/day
Fig.5
EC ( Epirubicin + Cyclophosphamide)

55%

1025%

30%
Fig. 6437.520)

Fig. 7

Fig. 5 Risk Factors of hiccups, adjusted odds ratio by multiple logistic regression.
Patients who received cisplatin-containing chemotherapy at Kanazawa University Hospital or National Hospital Organization
Kanazawa Medical Centre, from April to September in 2007. There were 40 patients with hiccups and 122 patients without
hiccups. All risk factors adjusted odds ratio by multiple logistic regression method. (Ref. 19)

Fig. 6 Definition expressing the degree to which febrile neutropenia
Definition expressing the degree to which febrile neutropenia is blunted.
The gray line shows examples of body temperature variation. TBRE:
the time to body temperature reaching 37.5

from the time when bodytemperature exceeded the baseline temperature, TABE: the time toFig. 7 Correlation between TABE and daily dose of prednisolone
in the multiday group

antimicrobial administration from the time when body temperature

Correlation between TABE and daily dose of prednisolone in theexceeded the baseline temperature, TABR: the time to antimicrobial

multiday group. TABE increased with an increase in the daily dose ofadministration from the time when body temperature reached 37.5

prednisolone (R = 0.45, P = 0.003, Spearman.

s rank correlation

The judgment of exceeding baseline temperature was defined ascoefficient). TABE: the time to antimicrobial administration from thedirectly related to reaching 37.5

time when body temperature exceeded the baseline temperature. (Ref.

. TABR values can be negative. (Ref.

20)

20)

1126)

11.
21)

22)

Holle
23)

Hashimoto24)
27)

5-HT3NK1
4

PharmD
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33.9%

PhD28)

84.5%
25)

12

REFERENCES29)

30)

313
92
31024929009
20132022
MSKCC

23
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