The Cubixx ® system seamlessly monitors the storage status of medicines by using wireless networks, enabling the return and lot exchange of medicines stored under non-room temperature conditions, which was generally impossible previously. To evaluate the availability of the Cubixx ® system, we surveyed recent trends in the Japanese pharmaceutical market, status of pharmaceutical purchases, and status of the use of the Cubixx ® system in Yokohama City University Hospital.The Japanese pharmaceutical market continued to grow from 2007 to 2019 (P < 0.001). There are 11 pharmaceutical therapeutic categories (hereinafter referred to as "correlated categories") that have a statistically positive correlation with the expansion of the total output (P < 0.001). In the targeted period, most medicines newly listed on the NIH price list (67.9％) belong to correlated categories, and the ratio of injection medicines stored at non-room temperature which are expensive has increased. 96.7％ of A-ranked medicines with ABC analysis in Yokohama City University Hospital are injection medicines, which tend to be expensive and stored at non-room temperature. 85％ of A-ranked items belong to correlated categories. Due to the use of the Cubixx ® system, the targeted medicines were never discarded during the targeted period. The total amount of returned medicines during the period accounted for 62.3％ of the total. The recent Japanese pharmaceutical market has continued to grow, with the increase in newly released injection medications which belong to correlated categories, are stored at non-room temperature, and expensive. The Cubixx ® system may be useful in the inventory management of these medicines.

Introduction:The duration of antimicrobial therapy is a critical evaluation index of antimicrobial stewardship (AS). The inclusion of the dosing period on package inserts provides a strong reason for clinical intervention by pharmacists in cases where physicians prescribe inappropriate dosing periods. This study investigated differences in the description of dosing periods in antimicrobial package inserts between Japan and the U.S. Methods:We conducted a survey comparing differences in the dosing period of oral and injectable antimicrobials approved and marketed in Japan and the U.S. as of May 1, 2021. The Fisher exact test was used to compare the presence or absence of a description of the dosing period on the package insert between these two countries.Results: We evaluated 69 antimicrobial agents, of which 34 were oral; and 35 were injectable agents. In Japan, 20 (29.0%) of the antimicrobials had package inserts stating the dosing periods, compared with 58 (84.1%) in the U.S. (p < 0.001). Conclusions:It was found that the information on the duration of administration was missing from the package insert in Japan compared to the U.S. Lack of information on the duration of administration may lead to long-term administration by the treating physician and also make it difficult for the pharmacist to inquire about the administration. It is expected that the inclusion of scientifically-based dosing periods in all package inserts will promote AS among physicians and pharmacists who are not specialists in infectious disease therapy.