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Effectiveness of polypharmacy reduction policy in Japan: nationwide retrospective observational study

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Abstract

Background Polypharmacy is an important global health issue. In Japan, an amended policy has been implemented since April 2016 to offer incentives that allow claiming a payment of approximately 22.5 US$ per patient to hospitals and clinics that succeed to reduce two or more medications. However, there is no evidence on the nationwide effectiveness of polypharmacy reduction policy. Aim To evaluate the effectiveness of the polypharmacy reduction policy in Japan using nationwide outpatient prescription fee reimbursement claims data in Open Data of the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Method This nationwide retrospective observational study was conducted over 3 years (April 2015 to March 2018). The primary outcome was the polypharmacy reduction ratio calculated by the polypharmacy proportion. Factors associated with policy effectiveness were identified by performing a multiple linear regression analysis using independent variables. Results After implementing the new policy, a 7.3 % polypharmacy reduction ratio was observed, particularly in the elderly (8.2 %). Multiple linear regression analysis revealed that the proportion of elderly residents (aged ≥65 years), number of hospitals per 100,000 residents, and number of clinics per 100,000 residents were statistically significantly associated with this reduction. Conclusion The polypharmacy reduction policy indicated an association with polypharmacy reduction in Japan. The proportion of elderly residents and availability of hospitals and clinics are important factors to enhance the effectiveness of the polypharmacy reduction policy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Graduate School of Public Health, Teikyo University, Itabashi-ku, 173-8605, Tokyo, Japan

    Takehiro Ishida, Kazue Yamaoka, Asuka Suzuki & Yoshinori Nakata

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  1. Takehiro Ishida
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  2. Kazue Yamaoka
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Correspondence to Takehiro Ishida.

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Takehiro Ishida is an employee of Bristol Myers Squibb KK.

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This study did not require informed consent for participation because all data used are publicly available anonymously aggregated data in accordance with the current Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan.

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This study did not require informed consent for publication because all data are publicly available anonymously aggregated data used in accordance with the current Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan.

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Ishida, T., Yamaoka, K., Suzuki, A. et al. Effectiveness of polypharmacy reduction policy in Japan: nationwide retrospective observational study. Int J Clin Pharm 44, 357–365 (2022). https://doi.org/10.1007/s11096-021-01347-7

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