Japan on Friday passed legislation to raise co-payments for prescription medicines with ingredients and effects similar to over-the-counter (OTC) drugs, in a bid to curb insurance premium hikes for the working population.

The bill to reform the nation¡¯s healthcare insurance system, which passed by a majority vote in the Upper House¡¯s plenary session, would also make costs associated with childbirth entirely covered by public health insurance.

Currently, standard deliveries are not covered by public health insurance, and women who give birth are granted a one-time allowance of ?500,000 ($3,130) per child. But the actual cost of child delivery varies among hospitals, making the lump-sum payment often insufficient.

The government is likely to start implementing the new system for childbirth costs within two years.

As for medication payments, the health ministry plans to require individuals to bear additional costs for some 1,100 OTC-like prescription drugs containing 77 ingredients starting in March 2027, with plans to expand the number of medicines subject to the change. The targeted ingredients include the antiviral ingredient aciclovir, the anti-inflammatory drug ibuprofen, ethanol and iodine used as disinfectants, and corticosteroid drugs.

These drugs cover a wide range of common and relatively mild ailments, such as stomachache, heartburn, constipation, pain and fever, athlete¡¯s foot and mouth ulcers. They will still be partially covered by public health insurance.

Patients will pay a special fee outside of insurance, which will be 25% of the total price of the medication. So if the price of the drug is ?1,000, for example, patients will pay ?250 as the special fee. Then, they will pay 10% to 30% of the remaining price once the special fee is subtracted (in this case, ?750). Most working people pay 30% under public health insurance, meaning they would pay a total of ?475 if a medication is ?1,000. That would be an increase of ?175 from the present ?300.

This means, for example, that if a patient is prescribed anti-allergy medicine for 30 days, the price to be paid at the counter for the prescription drug will rise from ?540 to ?855, compared with ?1,000 for an OTC drug containing the same ingredients.

The ministry has said it will exempt people with chronic conditions, such as those with intractable diseases and cancer, as well as children and low-income earners, from the additional out-of-pocket expenses.

The government will also revise calculations for insurance premiums and co-payments for those age 75 and over to incorporate financial income including stock dividends. This new system will be rolled out around 2030 in a move aimed at aligning medical fees with people¡¯s ability to pay.