overmedication has been reported as an area for concern in japan and is an area on which the ministry is taking fee schedulebased action through adjusting prescribing fees and prescription fees when more certain drugs are prescribed simultaneously in cases where more than three anxiolytics or sleeping drugs are prescribed or more than four antidepressants or antipsychotics such policy and indeed quality efforts more widely would be very much supported by a broader arrange of relevant quality activities for example systematic collection of data on prescribing practice and good clinical guidelines a number of quality indicators are in fact under development by a small but impressive group of hospitals led by national centre of neurology and psychiatry and such efforts should be promoted