Examination of Medical Care Fees in the National Health Insurance System by Phrarmacist-examiner. (I). Present Status and Problem of Examination of Pharmacist's Fee Claim Forms.

The pharmacist-examiner's business at the National Health Insurance Examination Committee of Medical Fees (NHIECMF) in Fukushima Prefecture is described. The most important business of pharmacist-examiner in the committee comprises two parts. One is examination of the pharmacist's fee claim forms and the issue of cautions, and the other is the explanation of various notifications concerning medicine at conferences attended by all examiners including doctors and dentists.We recognize four problems concerning the pharmacist-examiner's role in NHIECMF system:1) The number of pharmacist-examiner is so few that pharmacist-examiner can hardly contribute to safe and cost-effective use of medicines, 2) The pharmacist-examiner has no power to delete medical fees for unnecessary treatments, 3) The pharmacist-examiner cannot confirm whether the usage of medicines is suitable for the presented indications or not because there is no column describing patient's diseases in the phamacist's fee claim form, and 4) It is impossible for the pharmacist-examiner to check pharmaceutical management and counseling service.It is therefore necessary for us to improve these problems immediately.