Japan to introduce additional costs for OTC-like drugs under health insurance

The Japanese government plans to revise health insurance coverage for Over-the-Counter (OTC) similar drugs starting in March 2027. Under the new policy, patients will be required to pay an additional fee equivalent to one-quarter of the drug cost for approximately 1,100 items across 77 ingredients, covering common ailments such as nasal congestion, stomach pain, and inflammation.

The Federation of National Health Insurance Physicians has criticized the move, arguing that it imposes an unreasonable administrative burden on medical facilities. They noted that doctors would face nine new tasks unrelated to clinical treatment, potentially increasing patient wait times and costs. The Federation also expressed concern that the rules lack medical evidence and could lead to disputes with patients, particularly regarding low-income individuals.

In response, Health Minister Ueno stated that the government is not currently considering financial support for medical institutions to cover system updates or administrative costs. Instead, the Ministry intends to provide clear standards for electronic medical record vendors and create simplified checklists for clinics that have not yet implemented electronic systems.

While the Japan Medical Association warns that increased costs might discourage patients from seeking necessary medical consultations, proponents of the reform argue that the change is a necessary step to prevent social insurance funds from subsidizing drugs that are readily available for purchase at drugstores.