DESIGN: A Stock-and-Flow simulation model was used to project smoking prevalence and mortality from 2018 to 2050 under eight different scenarios: (1) maintaining the 2018 status quo, (2) implementation of smoke-free policies, (3) tobacco use cessation programmes, (4-5) health warning about the dangers of tobacco (labels, mass media), (6) enforcement of tobacco advertising bans or (7) tobacco taxation at the highest recommended level and (8) all these interventions combined.

RESULTS: Under the status quo, the smoking prevalence in Japan will decrease from 29.6% to 15.5% in men and 8.3% to 4.7% in women by 2050. Full implementation of MPOWER will accelerate this trend, dropping the prevalence to 10.6% in men and 3.2% in women, and save nearly a quarter million deaths by 2050. This reduction implies that Japan will only attain the current national target of 12% overall smoking prevalence in 2033, 8 years earlier than it would with the status quo (in 2041), a significant delay from the national government's 2022 deadline.

Methods: This cross-sectional study uses a pre-validated, self-administered questionnaire, which has been administered to 200 residents in Jitra, Kedah, Malaysia. Descriptive and inferential statistics have been used to analyse the data.

Results: Females formed 64.0% of the participants, with Malay being the dominant ethnic group (n = 167, 83.5%); 77.5% of the participants reported they were aware of the role of pharmacists in the healthcare system. However, 35.0% of the participants reported having never heard the term 'dispensing separation' in any mainstream media in Malaysia, whereas 73.5% of the participants reported that a pharmacist was more reliable than a physician in providing medicines once the diagnosis had been made and 77.5% of them acknowledged that pharmacists were experts in the field of medication. There was a significant association between the participant's awareness and the agreement on perceptions toward the implementation of the DS (P < 0.05).

METHODS: We selected two medicines on the 2013 Thai national list of essential medicines (NLEM) [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product.

RESULTS: Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007-2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366-923) to 3683 (95% CI 2,748-4,618); for imatinib from 103 (95% CI 72-174) to 350 (95% CI 307-398); and for trastuzumab from 68 (95% CI 45-118) to 412 (95% CI 344-563).