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Top1. Background
Under pandemic outbreak conditions, where many patients need to be treated at the same time, it is impossible for doctors to see, treat, and prescribe medication individually for each patient, or for pharmacists to provide medication counseling and explain precautions to each patient face-to-face. Thus, patients may be required take medication themselves without the benefit of treatment by doctor or counseling by a pharmacist. The act of taking medication at one’s discretion without a doctor’s diagnosis or pharmacist’s face-to-face medication counseling is called self-medication. Targeted antivirus prophylaxis (TAP) is a policy that allows suitable antivirus tablets to be distributed to citizens before the outbreak of a pandemic. TAP involving self-medication during a pandemic is considered to be a medical policy that should be enacted in the future (Bolle et al., 2008; Evans, 2021; Malik et al., 2020; Nakajima, 2020; Nasir et al., 2020; Wegbom et al., 2020).
Self-medication has a long history, and it goes without saying that it involves substantial risks. What can be done to reduce these risks? In this manuscript, based on a survey on the distribution of an iodine preparation for self-medication immediately after the Fukushima nuclear power plant accident and a simulation of scale-free networks in a pandemic outbreak environment, we assumed a regular population topology and manipulated various factors involving information and communications technologies (ICTs; e.g., mobile phones, the Internet, broadcasting services) in order to identify problems and thus to reduce risks.
1.1 Definition
Here, TAP is defined as the advance distribution of antiviral drugs to citizens as a public health policy measure against a pandemic outbreak. Self-medication is defined as citizens purchasing medicines from pharmacies over the Internet, selling medicines over the Internet, or storing previously prescribed medicines and taking them at a later time at their own discretion. TAP is a policy for social disasters, and thus it closely resembles the distribution and administration of iodine preparations associated with nuclear power plant accidents, whereas self-medication has increased in recent years because the spread of the Internet has made it relatively easy to purchase drugs. TAP is also an indispensable social system in developing countries for citizens who cannot afford to visit a doctor. Needless to say, face-to-face consultations with doctors and pharmacists do not take place under TAP or under self-medication conditions.
1.2 Self-Medication
Self-medication has a long history. In Egypt, India, and China, it was common practice to decoct medicinal herbs to suit one’s physical condition, and in Fijian festivals, kina (a kind of herb used to induce mass hypnosis) has historically been used as self-medication. As a rule, however, self-medication usually involves a fairly weak medicine with only mild effects.
Japan has had a unique system of selling medicines beginning 300 years ago in the Edo period. With the permission of the Edo shogunate, the Kaga clan (present-day Kanazawa) had a policy of selling medicines, and merchants in Toyama distributed “deployment medicines” throughout Japan, either on foot or on horseback. In modern times, this system involves visiting each household and distributing sets of household medicines, such as stomach and cold medicines, laxatives, and painkillers.
The concept of this business model, “use-first pay-later”, which first appeared in Toyama, was unique in Japan. Each household paid a visiting merchant for the medicines used during the year, after which, the merchant would replenish the medicines, record the details of the visit in a notebook, and visit the home again one year later (2021).
With the implementation of universal health-care in Japan in 1961, the number of people visiting a doctor even for minor illnesses increased, which led to a new financial problem for the government: escalating national health-care costs. Against this background, Toyama’s “use-first pay-later” system, which helped promote the idea of self-medication, that is, curing minor illnesses by oneself, can be seen to have contributed to lowering annual medical care costs by over 40 trillion yen.