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Prescription, Nonprescription and Orphan Drugs01:02

Prescription, Nonprescription and Orphan Drugs

Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
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Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...

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Unfilled Prescriptions in Japan: A 10-Year Retrospective Analysis.

Yuki Kataoka1,2,3,4,5,6, Yudai Tamada6, Takahiro Tabuchi7

  • 1Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan.

Pharmacoepidemiology and Drug Safety
|January 16, 2026
PubMed
Summary

Primary medication non-adherence (PMN) in Japan remained stable at approximately 5% over ten years. This study highlights the need for health insurers to develop systems for alerting providers about unfilled prescriptions.

Keywords:
medication adherencepharmacy dispensingprimary medication non‐adherence

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Area of Science:

  • Health Services Research
  • Pharmaceutical Policy
  • Public Health

Background:

  • Universal healthcare coverage in Japan aims to ensure medication access.
  • Understanding medication non-adherence patterns is crucial for optimizing treatment outcomes.
  • Primary medication non-adherence (PMN), defined as failure to fill new prescriptions, impacts healthcare system efficiency.

Purpose of the Study:

  • To characterize temporal trends in primary medication non-adherence (PMN) in Japan.
  • To analyze PMN patterns over a decade (2014-2023) within a universal healthcare system.
  • To identify variations in PMN across different patient demographics and disease states.

Main Methods:

  • Retrospective cohort study utilizing the DeSC Healthcare database.
  • Analysis of Japanese medical claims and pharmacy dispensing records from April 2014 to September 2023.
  • Definition of PMN as the absence of a dispensing record post-prescription issuance.

Main Results:

  • Over 2.6 million medical claims from nearly 2 million patients were analyzed.
  • Overall PMN proportion was 4.9%, decreasing from 5.6% in 2014 to 4.3% in 2023.
  • Disease-specific PMN varied, ranging from 4.0% for hypertension to 7.0% for spinal disorders.

Conclusions:

  • Primary medication non-adherence (PMN) remained consistently around 5% throughout the study period in Japan.
  • Recommends health insurers implement notification systems for unfilled prescriptions to alert healthcare providers.
  • Suggests future research should investigate the impact of electronic prescribing systems on PMN rates.