Japan to Review Insurance Coverage for OTC Drug-Like Medicines

Tokyo, Nov. 10 (Jiji Press)–The Japanese health ministry is beginning full-scale discussions on a proposal to review the public health insurance coverage of prescription medicines whose ingredients and effects are similar to over-the-counter drugs. The move comes after suggestions that the increase in the country’s medical expenditures may be attributed in part to the fact that such prescription medicines can be purchased at lower cost than OTC drugs. The ministry is considering a plan to increase out-of-pocket payments for OTC drug-like medicines while keeping a framework for prescriptions by doctors in place. Japan’s ruling Liberal Democratic Party, its new coalition partner Nippon Ishin no Kai (Japan Innovation Party) and Komeito, now an opposition party, agreed in June to review the insurance coverage for such medicines, aiming to lower insurance premium payments for the working generation. The three-party agreement also called for ensuring necessary medical examinations and taking into consideration the burdens borne by patients with chronic diseases and low-income individuals. A subcommittee of the Social Security Council, which advises the health minister, is set to reach a conclusion on the matter by the end of the year. Prescription medicines similar to OTC drugs are often for mild symptoms, such as pain relief patches, moisturizers and hay fever medication. Although the prices of the medicines include fees for doctors and pharmacists, patients only pay between 10 pct and 30 pct of the cost thanks to insurance. Nippon Ishin has called for drastically curbing medical expenses by excluding such medicines from insurance coverage. Meanwhile, the prices of some OTC drugs are more than 10 times higher than those of similar prescription medicines, due to additional advertising costs. The Japan Medical Association has opposed excluding such prescription medicines from insurance coverage, warning that not having patients receive medical examinations by doctors could lead to serious symptoms and side effects. The health ministry is mainly considering a plan to make patients pay surcharges on medicine fees for OTC drug-like prescription medicines, while keeping out-of-pocket payments for doctor and pharmacist fees unchanged. Defining the scope of medicines for insurance coverage review is also a major issue. One member of the Social Security Council subcommittee has proposed that the review be done in stages, starting with low-risk medicines. END [Copyright The Jiji Press, Ltd.]