Japanese Health Insurance Move To Double Drug Cost

Japan's coalition government, led by the Liberal Democratic Party, hasreached consensus on reform of the medical insurance system that is likely to double drug costs to outpatients. This will replace an earlier plan drafted last December that would put a surcharge on outpatients.

The new plan will require additional payments of 400 yen ($3.16) from outpatients who are prescribed two to three kinds of drug, 700 yen for those prescribed four to five drugs and 1,000 yen for patients with six or more drugs on their script. Outpatients receiving only one drug will not be charged additionally. The coalition government passed the bill containing these revisions through the Lower House last week, and it is expected to take effect from September 1.

Under the present Japanese comprehensive health insurance system, Japanese doctors and hospitals derive a large part of their income from the price differential (yakkasa) between the wholesale price and the official reimbursement price of drugs. And, since the cost of prescription drugs is included in the overall medical fees paid by the patient, there is little awareness of the cost of drugs, which account for almost one third of the health care budget, compared with 20% or less in other industrialized countries.