Japan's Upper House passed an amended Health Insurance Law on Friday, introducing additional costs for medications that have equivalent over-the-counter versions [1].
The law aims to curb rising medical expenditures and reduce the social insurance premium burden on the working-age population [1]. By shifting costs for common medications to the consumer, the government seeks to ensure the long-term sustainability of the national healthcare system.
Under the new system, patients will pay an additional 25% [2] of the drug price for approximately 1,100 items [2] classified as OTC-similar drugs. These are prescription medications with ingredients and efficacy similar to those available without a prescription.
To protect vulnerable populations, the government said that patients with cancer or intractable diseases will be exempt from these additional charges. Children will also be excluded from the burden [3].
Beyond the drug pricing changes, the legislation includes a review of the upper limits of the high-cost medical expense benefit system. It also mandates that childbirth expenses will be fully covered by public insurance [2].
Senate Speaker Sekiguchi said the bill passed during the plenary session, stating, "Accordingly, this bill has been approved and established" [1].
Government officials said the new system is scheduled to be implemented starting in March 2027 [4].
“Patients will pay an additional 25% of the drug price for approximately 1,100 items.”
This legislative shift signals a transition in Japan's healthcare philosophy, moving away from comprehensive state coverage for mild ailments toward a model where patients share more cost for non-critical care. By targeting 'OTC-similar' drugs, the government is attempting to incentivize the use of pharmacy-bought medicines over physician-prescribed ones, thereby reducing the strain on the public insurance fund as the population ages.
