健康保險支付制度之藥事服務費相 關規定，為保障用藥安全與藥師專業之關鍵。為了解臺灣與日本保險特約藥局 藥事服務費支付現況之差異，本文依據我國「全民健康保險醫療費用支付標準」調劑部分與日本厚生勞動省公告之調劑 報酬相關規定，進行比對分析。日本保險特約藥局調劑處方所申報之藥事服務 費，依性質可分成調劑基本費、調劑費、加計費、藥事照顧暨判斷性服務費四大 項目；臺灣健保特約藥局之藥事服務費 於實質上主要支付技術性調劑部份。若 依雙方支付標準估算調劑一張三天份門 診處方箋，臺灣基層社區藥局可申報之 藥事服務費，為新臺幣 40 元，約佔西元2006年臺灣平均每人國內生產毛額( gross    domestic   product,   GDP ）之0.008%；日本藥局藥師可申報之藥事服 務費，約新臺幣 325 元（1160 日圓）， 佔2006年日本平 均每人GDP 之0.028%；其中，50%屬於技術性調劑部份（調劑基本費與調劑費），此服務價值 約為臺灣之 1.75 倍；再加上另外50%之知識性服務（包括用藥指導、藥品資訊提供、藥歷建檔與管理）所支付之費用， 使日本藥事服務費服務價值增為臺灣之3.5 倍。本文列舉日本藥事服務費支付項目之獨特性，例如處理重複用藥與藥品 交互作用、用藥指導、藥歷建檔管理等給付，期能作為國內界定藥事服務費以及設置支付項目之參考。 
 

The relevant regulations for reimbursement of pharmaceutical care are the  keys to  ensure medication safety and professionalism of pharmacists.The purpose of this study was to investigate the current status of pharmacy service fees covered by national insurance in Taiwan and Japan.Cross comparison and analysis was performed based on the pharmaceutical care fee of “National Health Insurance (NHI) reimbursement standard for medical expenses”in Taiwan and reimbursement standards set by the Ministry of Health, Labor and Welfare (MHLW) in Japan.The entire payment for the medication therapy  services  provided  by  Japanese pharmacies can be divided into four major items, namely the   essential   fees,dispensing   fees, extra-service fees, and medication therapy management  (MTM)  fees. In  contrast,the service fee for NHI-contracted pharmacies in Taiwan is mainly for the technical part of dispensing.If  a  3-day  prescription is filled according to the reimbursement standards of both parties,pharmacists in Taiwan can receive NT$40 of pharmaceutical care fee, which is approximately 0.008% of the average 2006 GDP (gross domestic products) per person in Taiwan. Pharmacists in  Japan, on  the  other  hand, canreceive  NT$  325  (￥1,160) of  pharmaceutical care fee, which is approximately 0.028% of the average 2006 GDP per person in Japan; within it,50% belongs to the technical part of dispensing (essential fees and dispensing fees), which is 1.75 times  the  value of  pharmaceutical care fee  in Taiwan.With the additional 50% of MTM fees paid, the value of pharmaceutical care fees in Japan ends up to be 3.5 times that in Taiwan.The payment for MTM services in Japan,e.g.medication counseling and education,provision of drug  information,drug history taking, avoiding redundant medications use and drug interactions,can be regarded as a reference for NHI in further defining and reimbursing the pharmacy for MTM services in Taiwan.