[Shift to home treatment and the function of pharmacies]

A crisis point has been reached in the medical health system in Japan, where there has been a rapid aging of the population. The method of providing health system benefits is being reconsidered. As a result, medical treatment has been classified into inpatient, outpatient, and home care systems according to treatment functions. In concrete terms, the insurance system now classifies medical treatment and care separately, payment for medical fees has changed from payment at piece rates to a fixed amount system, and the number of days patients stay in hospital has been reduced. It is predicted that hospital treatment will increasingly rely on early discharge, and patients highly reliant on medical treatment will be shifted to home treatment. For this shift to home treatment, therefore, supplies of injectable agents such as used in total parenteral nutrition, and equipment by specialist pharmacies have become necessary. However, to dispense injectable agents, "standards of compounded sterile pharmaceuticals by licensed pharmacies" is applied, meaning there are very few pharmacies that can meet these standards. In the present survey, we found that 40 pharmacies have been recognized as meeting these standards.