Marketing Approval of Ethical Kampo Medicines

[Standardization of Crude Drugs for the Japanese Pharmacopoeia]

The latest edition of the Japanese Pharmacopoeia (JP) is the second supplement to the 17th edition containing 324 herbal medicines, of which 176 are crude drugs and 35 are Kampo extracts. Although 148 prescription Kampo extracts are covered by national health insurance, only 35 are listed in the latest JP. However, the sales volume of these 35 Kampo extracts accounts for more than 70% of the total sales volume of Kampo products, as Kampo formulas with higher sales volumes are preferentially listed in the JP. The JP officially defines the origin and description of the listed crude drugs and Kampo extracts and elaborates on their limited values and testing methods. As crude drugs and Kampo extracts are derived from natural products and have the characteristics of traditional medicines, some degree of variation has been experienced during their long-term use, which is one of the crucial differences from chemical drugs. The Japanese Pharmacopoeia Committee on Crude Drugs promotes standardization of the JP by reflecting the actual Japanese market situation. This review explains the characteristics of natural and traditional medicines in crude drug-related items, the JP drafting process and points to be noted, and the significance of listing in the JP.

Japanese government research grants for Kampo medicine: aAn overview of 10 years (1997-2017)

Background

Japan has its own traditional medicine called Kampo medicine, but it is relatively unknown in compared to Traditional Chinese Medicine. Therefore, this study examined the current status of the research related to Kampo medicine supported by Japanese government research grants (JGRG).

Methods

Three databases were searched on October 2019: National Institute of Public Health, Grant-in-Aid for Scientific Research and Japan Agency for Medical Research and Development. The search keywords were Kampo medicine, acupuncture, integrative medicine, oriental medicine, and traditional medicine. The final research that satisfied the inclusion criteria were selected and analyzed.

Results

After a comprehensive search of the three database and removing any duplication research, 2246 JGRG (985 new proposal) that met the inclusion criteria were selected. The number and amount of JGRG have been increasing steadily. The basic research conducted by academic research institutes was mainstream, and the proportion of development research of new Kampo medical technology was low. Most J-research was non-clinical research and 21 % were clinical research. The largest research institute was the Toyama University and there were many non-clinical, cancer, and Juzentaihoto research. On the other hand, government grants were funded relatively evenly without bias to specific fields or institutions.

Conclusions

After analyzing the Japanese government research grants from 1973 to 2017, research on Kampo medicine, which barely had any interest previously, was revived in the 2000s. In particular, it increased sharply in the 2010s, and the research fields were relatively diverse.

Biopiracy versus One-World Medicine-From colonial relicts to global collaborative concepts

BACKGROUND

Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism.

HYPOTHESIS

The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe.

STUDY DESIGN

Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine.

CONCLUSION

To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients.