Japan to increase patient costs for OTC-like prescription drugs

Japan is preparing to implement a reform to its medical insurance system in March 2027, targeting drugs that are highly similar to over-the-counter (OTC) products. Under the new rules, patients will be required to pay a ‘special fee’ equivalent to one-quarter of the drug cost for 1,042 items across 77 components. The Ministry of Health, Labour and Welfare estimates this will reduce national medical expenditures by approximately 90 billion yen annually, potentially lowering social insurance premiums for the working generation by about 400 yen per person per year.

The Central Social Insurance Medical Council has been discussing the transition. While payers argue the move is essential for the sustainability of the healthcare system, medical providers have expressed concerns regarding the increased administrative burden on clinics and pharmacies. There are also worries that the complexity of the system—which includes exemptions for cancer, intractable diseases, and certain age groups—could lead to diagnostic delays or confusion.

Public opposition is growing, with a petition by the National Federation of Health Insurance Medical Practitioners collecting over 110,000 signatures. Patients with chronic conditions, such as rheumatoid arthritis and atopic dermatitis, have voiced fears that the new cost structure and the criteria for exemptions may make long-term treatment financially unsustainable or create new inequities among patients.