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Japan Proposes 25% Surcharge on OTC-Like Prescriptions, Naming 77 Ingredients

The Health Ministry frames the charge as a fairness step to ease insurance costs, with vulnerable patients exempt.

Overview

  • Officials presented the plan to the Social Security Council’s medical insurance subcommittee on Dec. 25 with a proposed start in March 2027, moving next to refine the list and draft legislation for the next Diet session.
  • Patients would pay a special fee equal to 25% of the drug price, while the remaining 75% stays covered by public insurance and is still subject to the usual 10–30% copay.
  • The initial scope spans 77 active ingredients across roughly 1,100 prescription items, including Loxonin, Allegra and Hirdouid gel.
  • Children, cancer patients and people with designated rare diseases or certain chronic conditions would be exempt from the added charge.
  • Projected savings remain unsettled, with reported estimates ranging from about ¥90 billion to ¥188 billion per year.