Overview
- The ruling coalition will keep OTC-like prescription medicines within insurance while adding fixed-rate patient payments under the hoken-gai heiyou ryouyou-hi scheme.
- Options under discussion would charge patients one-quarter, one-third, or one-half of the medicine’s price on selected items.
- The Japan Innovation Party has dropped its push to broadly exclude these drugs from coverage after concerns about steep out-of-pocket increases.
- The scope is unresolved, with Ishin seeking about 1,000 ingredients while the health ministry proposes a phased start from roughly 20 low-risk items linked to the self-medication tax list.
- Negotiators aim for a year-end agreement, submission to the 2026 ordinary Diet, and implementation in fiscal 2026, with exemptions being considered for children, chronic and rare disease patients, and low-income groups.