Economic and Legal Frameworks for Non-Prescription Medicines 2004 studied by AESGP 14. PHARMACY TRAINING AND ATTITUDES Statistics showed that in 2001 54% of all prescriptions were dispensed by physicians, with the remaining 46% being dispensed by pharmacists. In a climate where separation of dispensing from medical practice is still slow progress, pharmacists continue to depend on a large degree of the supply of non-prescription medicines and other healthcare products. As a result, many pharmacists are in favour of OTC recommendation. For the 6-year term of the faculty of pharmaceutical sciences, the Japan Pharmaceutical Society has compiled a recommendation for a model core curriculum. In this new model, the recognition and appropriate use of non-prescription medicines for responsible self-medication are clearly demonstrated. Each year, the Japan Pharmaceutical Association (JPA) holds a Scientific Symposium and, from time to time, requests the Japan Self-Medication Industry to participate by displaying representative non-prescription medicines in the venue of the Symposium. This may also involve the presentation of a keynote address or an ordinary speech. In 2003, the Japan Pharmacist Education Centre (JPEC) offered pharmacists a special training course on the use of OTC medicines. This was the first course specially focusing on OTCs for which the cooperation of JSMI had been requested. Further special training courses at the JPEC are under consideration. Each year, JSMI publishes a consumer brochure "Self-Medication Guide book" which aims to inform consumers on the proper use of non-prescription medicines in user-friendly terms, with the help of numerous cartoons and colourful illustrations. 200 000 copies are distributed to the national and local pharmaceutical affairs authorities, consumer centres, local pharmaceutical associations, and other relevant parties. The brochure is mainly used as a handy guidebook at the annual "Medicines and Health Week" jointly sponsored by the MHLW and the JPA. Since 1988, JSMI is every second year issuing and updating an "OTC Compendium" that incorporates the around 4 200 OTC medicines currently available on the market. The compilation of the 10th edition of the OTC Compendium was in progress in early 2005. 15. DOCTORS TRAINING AND ATTITUDES It is difficult to generalise the attitude of medical doctors towards OTC recommendation. However, it is probably fair to say that in the eyes of doctors as well as dentists, OTCs in Japan have an extremely low profile simply because OTC medicines are not subject to reimbursement under the health insurance scheme that theoretically covers the entire nation. On the other hand, the number of doctors and dentists is forever growing. Economically this means that competition among them is intensifying as the number of patients per doctor or dentist keeps diminishing year by year. It has become increasingly difficult for the medical profession to cope with this situation as was dramatically demonstrated by a recent increase in bankruptcies of medical institutions. There have been no contributions from the side of doctors and dentists regarding the promotion of self-medication with OTC medicines, and no course on OTCs is included in the training of medical doctors. In 2003, the World Medical Association (WMA) convened its general assembly in Tokyo, with the JSMI representing the World Self-Medication Industry (WSMI). As the dialogue the medical profession and industry is basically more active at the global than at the national level, such occasions may stimulate Japanese doctors to promote self-medication. In 2003, JSMI distributed some 800 copies of the 9th edition of the "OTC Compendium" to the major medical institutions in order to promote OTC medicines to medical practitioners.