Generic drugs and supplements

In today's newspaper, the ministry is aiming the dissemination of generic drugs (generic) embark on a strengthening of quality management, there was a article called. The generic drug, a medicine containing the same active ingredient as the off-patent drugs (original drug), is what another manufacturer manufacturing. Because it is inexpensive compared to the original drug, it is expected to lead to a reduction in medical costs (patient burden is also reduced). However, it is possible that there is anxiety in the quality and supply system, popular in Japan compared to Europe and the United States has been delayed. Therefore, the ministry is that embark on strengthening of quality control from next year for generic penetration. Specifically, so far for inspections to the manufacturing plant prefectures has been carried out, it is the content such as to ensure the country also performs. (It should be noted that generic even at present so we fart the examination as a medical drug, efficacy and safety does not mean pales in starter drugs. However, Toka not a leading manufacturer, seems certain things or something is large units sold to medical institutions. ) It is my opinion, but for also supplements and health foods, by introducing a similar management system, I think that it should promote the proper use. Health food in general is or suffered reputational damage due to improper product of a small portion, or walking alone without even enough commentary negative research data, is that it is often in supplements and health foods. If it is intended to health maintenance and disease prevention, the effectiveness evaluation may not be easy. On the other hand, since the remains of the current system does not take place collateral of safety, it is thought to have made aggressive use of the failure of supplements and health foods. If supplements and health food proper use is, medical expenses to bear country to will be reduced, it is estimated that (than from getting sick to take a medical institution) economic burden of individuals reduced You.

Necessary medical insurance system restructuring

Happy New Year. Thank you again this year. The end of last year, since the reunion Dutch acquaintance and his wife and the first time in a year, I tried to ask about the health care system of Europe. According to them, the Netherlands, the past, was a high-welfare state, now it is completely different, the health care system but are not such as can be very proud, and was saying. In fact, one in between people who are economically afford, rather than in the Netherlands or Europe, Thailand, Singapore, India and Malaysia, to be subject to medical care to stay in a country that is promoting medical tourism options and it has been established as is that. In these countries, doctors and health care workers who received training in the US and Europe is, has worked at the hospital for foreigners, we are poised medical care is received on the basis of the US treatment guidelines. Recently, in Japan the need for review of the social security system and medical insurance system has been recognized. This is also the same in the United States, in particular, ahead of the presidential election, medical insurance system has become one of the issue. In the United States of physician for professional journal (Ann Intern Med January 1, 2008), "in order to achieve an efficient health care system, the United States or we can learn from what other countries" is paper that It was initially published. (Original title "Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries" Ann Intern Med 2008; 148 55-75) In Japan there is a national health insurance system, but only in part to cover the public health insurance, such as Medicare and Medicaid in the United States, largely rely on private insurance system. Currently, 250 million people, which corresponds to 84.2 percent of the US population but will not subscribe to some sort of medical insurance, is 47 million people, which corresponds to 15.8% has become uninsured. Among the major developed countries, the only country which introduced market principles and economic rationalism in the medical field is the United States. In medicine biology research, but is the United States which runs the top in many areas, it does not seem to be in a state that many of the people subject to equally appropriate medical care. Let's look at the specific data. US Canada France Germany Japan Infant mortality rate (per 1000 births) 6.8 5.3 3.6 3.9 2.8 Average life expectancy 77.8 80.2 80.3 79 82 The number of doctors (1000 people per population) 2.4 2.2 3.4 3.4 2 MRI volume (per million population) 26.6 5.5 3.2 7.1 40.1 Medical expenditures (per capita $) 6401 3326 3374 3287 2358 Looking at this data, Japan, compared to other major European countries, despite the small doctor number and less health care costs, the infant mortality rate is the lowest, you can see that the longest average life span. (It should be noted that, since the different aggregation method of statistics by country, there is also a thing that can not be a simple comparison.) However, in the current Japan, especially in the obstetrics and pediatrics, it is a well-known fact of the medical field has been exhausted. As shown in this paper, in the current state of medical statistics, Japan is the most excellent results in developed countries. However, in this state, the medical field to collapse, it will be considered a matter of time. As soon as possible, it will probably require a review of the system. For example, for the lifestyle diseases that can be prevented by self-management, it will be required measures to put the emphasis on prevention than treatment. Health guidance in the area or workplace, is desired enhancement, such as public sports facilities. Alternatively, supplements and health food of the purchase cost, gym membership costs, such as expenses that were used in self-care, self-medication, it would be good to the deductible of the income tax. (Although it is necessary to verify the cost-effective.) In the current tax system, the use of medical expenses, self-pay worth more than a certain amount are income deduction. On the other hand, so as not to get sick, go to the gym, for example, by use of the supplement and health food, for the people who invest in their own health maintenance, it does not that the costs are deducted. In other words, people who are allowed to stand for the metabolic syndrome, in such as smokers, the disease occurs and progression by leaving the state, eventually public medical expenses is turned on, income tax is deductible for the self-pay amount , it is a mechanism that. Now though, the more cause if can fire a traffic accident, said the premium is lowered, it has become a strange structure. As a review of the system, (already introduced in some of the private insurance) increase in medical insurance for smokers, such as the significant tax increase of tobacco tax (already introduced in the United States and Europe) can say for granted. (At present, medical expenses paid for non-smokers, has been used to treat smokers sick. In the current tobacco tax, it is the amount that is not trivial at all. ) While ensuring the safe and secure medical care by the public insurance system, it is thought that there is a need to institutionalize also incentives for preventive medicine by promoting self-care.

Cost-effectiveness of nutritional improvement by supplements

To everyone that has been damaged by the Great East Japan Earthquake, I would the sympathy sincerely. Earliest possible restoration of the affected areas, we wish from the bottom of my heart reconstruction. Activities by the DHC is here. "About the support activities to the Great East Japan Earthquake disaster area" You can confirm from. Specialized journal (electronic version) of the month of clinical nutrition, nutritional interventions by oral administration of nutritional supplements, studies to verify the cost-effective, has been reported from a group of Germany. (Eur J Clin Nutr. 2011 Mar 16.) Administration of supplements, including the general nutrients, in patients cause malnutrition, it shows the effect of improving the general condition and QOL. In this study, the intervention effects of supplementation after discharge, the cost-effectiveness has been verified. Specifically, malnutrition patient 114 people caused by the digestive system diseases of benign (50.6 ± 16.1 years, of which women 57 people) to the subject, At the time of discharge, And nutrition counseling + supplementation conducted the intervention group (n = 60), And nutritional counseling only implemented the control group (n = 54) For three months intervention is taking place in two groups. With regard to nutrition improvement, indicators such as SF-36, QALYs (Quality-adjusted life years) are measured, For the verification of cost-effective, 2.30 euros as the minimum value per bag supplements, it has been set to 2.93 euros as the maximum value. In the intervention group, supplements of 2.4 ± 0.8 bags / day has been ingested. At the time of the start of the administration, there is no significant difference between the two groups with respect to nutritional status and health condition (0.594 ± 0.017 vs 0.619 ± 0.018). By three months of the intervention, in the supplementation group, as compared to the nutrition counseling group, it has been shown significant improvement (0.731 ± 0.015 vs 0.671 ± 0.016, P = 0.028). In the supplementation group, certain of the cost has occurred (ICER: \ [euro] 9497 and \ [euro] 12 099 / additional QALY, respectively) is, in the verification of cost-effectiveness, benefits are supported (<\ [euro] and is 50 000 / QALY) called. (In other words, by supplementation, a relatively small cost, it has improved the nutritional status and health condition was observed.) From the above data, the nutritional management after hospital discharge benign digestive system disease patients is suggested that the use of supplements is a cost-effective method useful. As a general rule, to the nutritional status improvement after surgery, Effectiveness is considered supplements, Multi-vitamin, Multi-mineral, DHA, EPA, CoQ10 And so on.

Supplements of economic efficiency (cost-effectiveness)

In recent years, we are advancing research on supplements and functional food ingredients. In particular, as a result of research reports on supplements and health foods has increased significantly during the last decade, certain findings on the safety and efficacy of supplements and functional food ingredients have been integrated. In fact, in the US medical database and search as a dietary supplement, you can see that the number of papers has been increasing rapidly. Once, supplements, there was a time to discuss the "safe whether" and "whether there is an effect." At present, it is in the stage of evidence provided on the proper use of "what the health and human condition, illness, or proper to administer any supplement product." For supplements and functional foods, also, the point to think about drugs, at the time of ingestion during / taking, ① safety, ② effectiveness, ③ economy Of it is three points. Safety of ① is natural. However, even if there is no quality of the product itself is a problem, by individuals of the constitution, do not fit a particular component, it can be no that. The course is also about the effectiveness of ②, but because the functional ingredient is not that equally valid for all people, it is important to choose a component to their purpose and symptoms. ③ of economic efficiency (cost-effectiveness) If health promotion and disease prevention purposes, the products one month to more than several thousand yen, would be inappropriate in terms of economic efficiency. 1 rather than type only, also I think often to take several types of supplements. If you take either a married couple or what kind in the family, if the total amount of one month than become tens of thousands of yen in the one household, the same amount of money, is better to use good quality ingredients and gym membership fee, to health maintenance you might say. In the medical drugs, have government of the major developed countries recommended the use of generic drugs (generic drugs). The better is, is also the burden of public health care costs, the burden of individuals and less, because it is an excellent way to cost-effectiveness. In clinical studies on supplements, studies have verified the economic efficiency (cost-effectiveness) is also now be found here and there. Cost-effectiveness of St. John's Wort in treating depression Cost-effectiveness of nutritional improvement by supplements Cost-effectiveness of glucosamine St. John's Wort, Against depression of moderate from mild, There is the same effect as SSRI or SNRI of pharmaceuticals, Fewer side effects, And, it is cost-effective herbs. DHC concentrated red yeast is, There are as effective as statin agent, Fewer side effects, It is a high cholesterol measures supplement cost-effective.

Supplements of economic efficiency (cost-effectiveness): Comparison with drug

Following yesterday, we want to consider supplements of economy the (cost-effectiveness). I tried to calculate the specific examples. ■ dyslipidemia (hyperlipidemia): statin agent vs. monascus (lovastatin) First, it is red yeast. Monascus, for the cholesterol-lowering effect, has the same effect with a statin agent, and has been known to be fewer side effects. In addition, cardiovascular events lowering effect is also shown, from the safety and efficacy, can be recommended to equal to or higher than that of the drug. Considering the cost-effectiveness (economy), prefer the DHC of concentrated red yeast, it is better than the statin agent. When I compared the drug prices, it looks like the following. And pharmaceuticals: statin agent (HMG-CoA reductase inhibitors) Mevalotin tablets (5mg) 54.00 円 Lipitor tablets (5mg) 59.40 円 Supplement: DHC concentrated red yeast 40.24 yen per grain DHC concentrated red yeast is the effect of as much as 5mg tablets of Mevalotin and Lipitor. (Although there are individual differences.) Because Mevalotin and Lipitor is also 10mg tablets, you can increase also concentrated red yeast as needed. (It should be noted, also concentrated red yeast statin agents are also recommended in combination with coenzyme Q10.) ■ Depression: SSRI vs. St. John's Wort Next, depression, compared with the SSRI medicines, in the St. John's Wort, for the depression of moderate from mild, there is the same effect as SSRI, and fewer side effects, we have established evidence that . (St. John's Wort is a high safety alone use, but you must be careful to adverse events due to the interaction of the drug.) Compared to the SSRI, St. John's Wort, it will be one of the cost of three minutes from half-price. And pharmaceuticals: SSRI Paxil tablets (5mg) 60.50 円 Jay Zoloft tablets (25mg) 106.00 円 Supplement: DHC St. John's Wort (extract powder 650mg) 29.74 yen per the 1st ■ Anti-Aging: ubidecarenone vs. coenzyme Q10 Coenzyme Q10, which is used widely in the field of anti-aging, anti-aging, there is also a product as a medicine. However, since the 1st dose is 30mg, it is the dose of prescription because 3 tablets 10mg tablets. In clinical trials, doses of around 100mg is common. For example, the DHC coenzyme Q10 has 90mg contain per two tablets a day. It also contains 35mg per bag to DHC Protein diet. And pharmaceuticals: Noikinon Tablets (10mg) 18.8 円 ⇒ 90mg = 169.20 円 Supplement: DHC coenzyme Q10 (45mg) 12.50 円 ⇒ 90mg = 25.00 円 When compared with per day 90mg, more of the supplements is the cost of a fraction of the drug. ■ vitamin D: Erude Caliciviridae tall (active form of vitamin D3 formulation) vs. vitamin D3 Vitamin D has been known variety of acts such as the immunomodulatory effects and anti-cancer effect. Pharmaceuticals is the active form of vitamin D, it is a prescription for the treatment of osteoporosis. Supplements, vitamin D3 is common, will be absorbed into the body in its active form. And pharmaceuticals: Eddie roll capsule (0.5μg) 68.5 円 Supplement: DHC vitamin D3 (25μg; 1,000 IU) 10 yen per the 1st In addition, drugs, will be the insurance adaptation, so the actual copayment is 30%. Therefore, the above drug prices, the difference between the price of supplements, has become larger than the actual copayment. However, in the case of pharmaceutical products, in addition to the prescription charge, payment of examination fees and prescription of a medical institution is required. In particular, If the self-pay 30 percent, First, in the hospitals and clinics, First, re-examination fee ¥ 810, total 1210 yen of dosing fee 399 yen is the self-pay. Next, in the pharmacy, Dispensing technology fee and pharmacy management fee, it will be added in addition to the drug charge is the price of medicine. Supplements, first, will be used for health maintenance, disease prevention. In this case, the health effects of vitamins and minerals, has antioxidant and anti-inflammatory effects of the functional food ingredient works. On the other hand, when it is utilized for improvement of certain diseases or conditions, And wide there are many available that have been functional food ingredient as a supplement rather than as a pharmaceutical product. In addition, safety and efficacy, when you think about the economy, as described above, there is the same effect as pharmaceuticals, high safety, also known excellent supplement ingredient to economic efficiency.