The Japanese government is implementing an amendment to the Health Insurance Law that adds an extra patient charge for prescription drugs similar to over-the-counter medicines.
This policy shift seeks to reduce the social-insurance premium burden on the working generation by curbing the growth of national medical expenses. By increasing the cost for patients to obtain these specific prescriptions, the government hopes to encourage the purchase of non-prescription alternatives.
The amendment is expected to be enacted on May 29, 2026 [1]. Under the new rules, patients will face an additional charge equal to 25% of the drug price [2]. This surcharge applies to approximately 1,100 drug items categorized as OTC-similar medicines [3].
Prime Minister Takaichi said the measure during proceedings in the Diet's House of Councillors. The administration views this as one of several necessary steps to ensure the sustainability of the healthcare system.
"It is necessary to strive to reduce the burden of insurance premiums by accumulating various reforms, not only the review of OTC-similar drugs," Takaichi said [4].
The move targets medicines that are widely available without a prescription but are often prescribed by doctors, thereby increasing the cost to the public insurance system. The government believes that shifting the consumption of these items to the over-the-counter market will lower the overall expenditure of the national health insurance fund.
“Patients will face an additional charge equal to 25% of the drug price”
This policy reflects Japan's ongoing struggle to maintain a universal healthcare system amidst an aging population and rising costs. By targeting 'OTC-similar' drugs, the government is attempting to shift the financial burden of low-risk, common medications from the state insurance pool to the individual consumer. This may lead to higher out-of-pocket costs for patients but is intended to prevent the insurance premiums for the working-age population from rising further.
