## Separation of Dispensing and Prescribing Functions

## Overview

## Separation of Dispensing and Prescribing Functions

Separation of dispensing and prescribing functions in improving the quality of national medical care by dividing the roles of doctors and pharmacists based on their specialized field in that doctors will issue prescriptions to patients and the pharmacists of pharmacies then dispense according to those prescriptions.

[Advantages of separation of dispensing and prescribing functions]

1) Doctors and dentists can freely prescribe drugs necessary for patients even when the particular drugs are not stocked in their own hospitals or clinics.

2) Issuing prescriptions to patients allows them to know which drugs they are taking.

3) "Family pharmacies" can check for duplicate prescriptions, drugs interactions, etc. offered by multiple facilities through drug history management and thus improve efficacy and safety of drug therapies.

4) Reduced outpatient dispensing work of hospital pharmacists allows them to engage in hospital activities for inpatients which they should essentially perform.

5) Pharmacists, in cooperation with prescribing physicians and dentists, will explain effects, side effects, directions for use, etc. of drugs to patients (patient compliance instruction) so that patients improve their understanding on drugs and are expected to take dispensed drugs as directed leading to improved efficacy and safety of drug therapies.

Detailed Data Changes in Number of Pharmacies and Prescriptions

FY	Number of pharmacies	Number of prescriptions (10,000/year)	Number of prescriptions per 1,000 persons (per month)	Nationwide average rate of separation of dispensing and prescribing functions (%)
FY1989	36,670	13,542	95.2	11.3
FY1990	36,981	14,573	105.4	12.0
FY1991	36,979	15,957	111.7	12.8
FY1992	37,532	17,897	125.8	14.1
FY1993	38,077	20,149	140.6	15.8
FY1994	38,773	23,501	161.0	18.1
FY1995	39,433	26,508	182.5	20.3
FY1996	40,310	29,643	210.0	22.5
FY1997	42,412	33,782	238.1	26.0
FY1998	44,085	40,006	278.8	30.5
FY1999	45,171	45,537	307.3	34.8
FY2000	46,763	50,620	348.6	39.5
FY2001	48,252	55,960	393.7	44.5
FY2002	49,332	58,462	393.0	48.8
FY2003	49,956	59,812	418.8	51.6
FY2004	50,600	61,889	368.7	53.8
FY2005	51,233	64,508	425.2	54.1
FY2006	51,952	66,083	442.5	55.8
FY2007	52,539	68,375	481.0	57.2
FY2008	53,304	69,436	483.0	59.1
FY2009	53,642	70,222	494.1	60.7
FY2010	53,067 $ {}^{*} $	72,939	486.6	63.1
FY2011	54,780	74,396	498.3	65.1
FY2012	55,797	75,888	533.3	66.1

Source: The number of pharmacies as of December 31 of each year until 1996 and of the end of each fiscal year from 1997 on by Pharmaceutical and Food Safety Bureau, MHLW. The number of prescriptions, that per 1,000 persons, and nationwide average rate of separation by Japan Pharmaceutical Association.

(Note) The rate of separation of dispensing and prescribing functions is calculated as follows:

Rate of separation of dispensing and prescribing functions (%) = $ \frac{\text{Number of prescriptions to pharmacies}}{\text{Number of prescriptions issued to outpatients (total)}} $ ×100

$ ^{*} $ Miyagi Prefecture is not included due to the effect of the Great East Japan Earthquake.