OBJECTIVES: Despite enormous efforts to improve chronic renal diseases management, the lack of evidenced resources focusing on Japanese patients persists. In order to implement pharmacoeconomics and outcomes research contributing to daily healthcare, it is essential to review and quantify the series of consecutive cases at clinical levels. In collaboration with community hospitals in the Chiba area, we are currently developing a database to assess clinical outcomes, resource utilization and effectiveness in the fields of renal diseases. This presentation illustrates the framework and results of our pilot study. METHODS: At the first stage, our fieldwork team collected baseline data on medical records of 205 outpatients with chronic renal diseases at 5 hospitals. The data included patient profiles, drug history and clinical test history from September 1988 to April 2002. At the second stage, using the data and other resources, our pharmaceutical research team conducted retrospective approaches to assess the renal protective effects of angiotensin-converting-enzyme inhibitors (ACEIs). Those approaches included Meta-analysis, Survival-analysis and Regression-analysis. At the third stage, in collaboration with clinic physicians, our economic/managerial research team is reviewing the assessment to develop cost-effectiveness simulation scenarios for improvement in medical management. RESULTS: By using the slope of the regression line for the reciprocal serum creatinine, the median of a reprieve from chronic renal failure by ACEIs was estimated as 2.50 years regarding 7 cases. For example, in case of a 40-year-old man with the estimated reprieve of 2.19 years, the patient gained 2.37 years of really extended period. And follow-up interviews with the clinic physicians indicated that those reprieve estimates will contribute to their decisions in drug prescription and the medical management. CONCLUSIONS: The pilot study is not evidence-based and contains uncertainty regarding future decision-making in individual cases. However, to let Japanese people understand effectiveness of pharmacoeconomics and outcomes research, project initiative should be community-centric and get involved with multidisciplinary team from the beginning.