Japan's National Diet passed an amendment to the Health Insurance Act requiring patients to pay a special charge for certain prescribed medications [1].
The measure aims to sustain the national health-insurance system by curbing rising medical-care costs [3, 4]. By shifting a portion of the expense to the patient, the government intends to reduce the financial burden on the state for medications that are widely available as over-the-counter options [4].
Under the new law, patients prescribed drugs classified as OTC-like medicines must pay an additional 25% of the drug price as a non-insured special charge [1]. This classification covers approximately 1,100 drug items [1].
The legislative process concluded this week in Tokyo. The House of Councillors passed the amendment on May 25, 2026, with a vote of 166 in favor and 79 against [1, 2]. The House of Representatives subsequently passed the amendment on May 28, 2026 [2].
The policy targets medications that are functionally similar to those sold without a prescription. This shift encourages patients to purchase these items over-the-counter rather than seeking a prescription that is subsidized by the government [3].
There is conflicting information regarding the application of these charges to minors. Some reports indicate the amendment applies to all patients, including children [5], while other sources suggest children are exempt from the additional charge [3].
“Patients must pay an additional 25% of the drug price as a special charge”
This policy represents a strategic pivot in Japan's healthcare spending, moving away from full subsidies for medications that can be safely managed by consumers. By introducing a financial deterrent for prescriptions of common drugs, the government is attempting to balance the accessibility of medicine with the long-term solvency of its public health insurance system amid an aging population.
