{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:47:05Z","timestamp":1791665225376,"version":"4.3.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alcohol use disorder (AUD) is common worldwide, but the proportion of patients receiving pharmacotherapy remains low. In Japan, patterns of pharmacotherapy initiation for AUD have not been fully characterized. Here, we quantified the cumulative incidence of pharmacotherapy initiation among patients newly diagnosed with AUD in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a descriptive study using a Japanese insurance claims database. We created annual cohorts of adults aged 20\u201364\u00a0years who were newly diagnosed with AUD during fiscal years (FYs) 2012\u201321. Cumulative incidence for pharmacotherapy initiation was estimated, with death treated as a competing risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 13\u00a0936 patients. Across FY 2012\u201321 cohorts, mean age was 43.3\u201344.8\u00a0years and men accounted for 72.6%\u201379.3% of each cohort. At cohort entry (Day 0), the cumulative incidence of pharmacotherapy initiation rose from 18.0% in FY 2012 to 35.2% in FY 2021. The 1-year corresponding cumulative incidences were 28.1% and 44.9%, respectively. Market approval of acamprosate (FY 2013) and nalmefene (FY 2018) and the publication of Japan\u2019s AUD treatment guideline (FY 2018) were each followed by marked year-on-year increases in pharmacotherapy initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the observed incidence may have been inflated by Japan\u2019s reimbursement policy, which requires an AUD diagnosis before medication can be prescribed, pharmacotherapy initiation exceeded that reported in other countries and has increased steadily since FY 2012. Introduction of new drugs and guideline dissemination appear to have accelerated treatment initiation and substantially altered treatment practice. These findings can help clinicians and policy-makers close the persistent treatment gap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/alcalc\/agag005","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:19:31Z","timestamp":1768825171000},"source":"Crossref","is-referenced-by-count":2,"title":["Initiation of pharmacotherapy for alcohol use disorder in Japan: a longitudinal descriptive study"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5107-5856","authenticated-orcid":false,"given":"Misato","family":"Kitamura","sequence":"first","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University , Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501 ,","place":["Japan"]},{"name":"Medical Affairs, Viatris Pharmaceuticals Japan G.K. , Azabudai Hills Mori JP Tower, 1-3-1 Azabudai, Minato-ku, Tokyo 106-0041 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K.K ., Midtown Tower, 9-7-1 Akasaka, Minato-ku, Tokyo 107-6239 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University , Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"2026021600065561400_ref1","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1016\/S0140-6736(19)31775-1","article-title":"Alcohol use disorders","volume":"394","author":"Carvalho","year":"2019","journal-title":"Lancet"},{"key":"2026021600065561400_ref2","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1002\/pds.4435","article-title":"Classifying medical histories in US Medicare beneficiaries using fixed vs all-available look-back 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