This article was written by the NIPPON VISA & LIFE editorial team based on information from public organizations such as the national government and local governments. Rules and fees may differ depending on the city, ward, town or village where you live.
At pharmacies in Japan, you may be asked, “Would you like a generic (ジェネリック, kohatsu iyakuhin / 後発医薬品)?” A generic medicine has the same active ingredient as the brand-name medicine (先発医薬品, senpatsu iyakuhin: the medicine that was made first) and is cheaper. If you ask for the brand-name medicine when a generic is available, from June 2026 you pay a “special fee” (特別の料金) equal to one half of the price difference.
The Short Answer: When the Pharmacy Asks You
- A generic medicine has the same active ingredient as the brand-name medicine and has been reviewed and approved by the national government
- It is cheaper than the brand-name medicine, so your out-of-pocket cost for medicine becomes lower
- If you choose, by your own preference, a brand-name medicine that has a generic, you pay a “special fee” separately from your usual out-of-pocket share (10% to 30%)
- When the doctor decides that it is “medically necessary,” or when the pharmacy has no generic in stock, there is no special fee
- If you are not sure, talk to the doctor or pharmacist
For an overview of how to use hospitals and pharmacies, see How to See a Doctor in Japan: Choosing Between Hospitals and Clinics, What to Show at Reception, the Medical Questionnaire, Paying, and Getting Your Medicine at a Pharmacy.
(Sources: Ministry of Health, Labour and Welfare “If You Request a Brand-Name Medicine for a Medicine That Has a Generic, You Will Pay a Special Fee” (leaflet for patients), Ministry of Health, Labour and Welfare “Generic Medicines” leaflet)
What Is a Generic Medicine?
| Brand-name medicine (new drug) | Generic medicine (kohatsu iyakuhin) | |
|---|---|---|
| What it is | The medicine that was first developed and put on sale | A medicine made after the patent of the brand-name medicine has expired |
| Active ingredient | — | Contains the same ingredient in the same amount as the brand-name medicine |
| National review | — | The national government reviews and approves its effectiveness, safety and quality |
| Price (official drug price) | High | Cheaper because development costs less |
Generic medicines are made so that their effects (indications and effects) are the same as the brand-name medicine. However, there are cases where they differ, for example when the brand-name medicine later added a new indication.
The additives (materials other than the active ingredient) may differ from the brand-name medicine. Because of this, the color, shape or taste may be different. Some have been made easier to take using new technology.
Not every medicine has a generic version. Also, generic medicines are “prescription medicines” (医療用医薬品) that require a prescription (処方箋, shohosen: the instructions for medicine written by a doctor) from a doctor at a hospital or clinic.
(Sources: Ministry of Health, Labour and Welfare “Generic Medicines” leaflet, Ministry of Health, Labour and Welfare “Generic Medicine Request Sticker”, Ministry of Health, Labour and Welfare “Promoting the Use of Generic Medicines and Biosimilars”)
The “Special Fee” When You Choose a Brand-Name Medicine
How It Works
A brand-name medicine that has a generic version is called a “long-listed product” (長期収載品, choki shusaihin). If you choose a long-listed product by your own preference, you pay a “special fee” separately from your usual out-of-pocket share.
- This system started in October 2024
- From June 2026, the special fee became the amount equal to one half of the price difference between the brand-name medicine and the generic medicine
- Consumption tax is charged on the special fee
- Costs other than the price of the medicine, such as the consultation and dispensing fees, do not change
Example Calculation
The Ministry of Health, Labour and Welfare explains it with the following example.
| Price per tablet | |
|---|---|
| Brand-name medicine | 100 yen |
| Generic medicine | 60 yen |
| Price difference | 40 yen |
| Special fee (one half of the price difference) | 20 yen |
In this example, you pay 20 yen per tablet (plus consumption tax) separately from your usual out-of-pocket share of 10% to 30%.
- When there are several generic medicines, the fee is calculated from the difference with the most expensive one among them
- Because of rounding and similar processing, the amount may not be exactly one half
(Sources: Ministry of Health, Labour and Welfare “About the Selective Treatment for Long-Listed Products”, Ministry of Health, Labour and Welfare leaflet for patients, Ministry of Health, Labour and Welfare “Partial Revision of ‘Prescribing or Dispensing Long-Listed Products'” (March 27, 2026))
When There Is No Special Fee
| Situation | Special fee |
|---|---|
| The doctor decided it was medically necessary and prescribed the brand-name medicine | Not charged |
| The pharmacy has no generic medicine in stock and can only give you the brand-name medicine | Not charged |
| The pharmacist decided you should take the brand-name medicine, for example because the generic’s form is hard to take | May not be charged |
| You asked for the brand-name medicine for reasons unrelated to its effect, such as “how it feels to use” or “taste” | Charged |
If, for example, you have had a side effect from a generic medicine before, talk to a doctor, dentist or pharmacist.
(Sources: Ministry of Health, Labour and Welfare leaflet for patients (Q3 and Q4), Ministry of Health, Labour and Welfare “Partial Revision of ‘Prescribing or Dispensing Long-Listed Products'”)
What Should You Look at on the Prescription?
Since October 2024, prescriptions have the following 2 boxes. When a medicine applies, the doctor writes “✓” or “×” for each medicine.
| Box | Meaning |
|---|---|
| Change not allowed (medically necessary) (変更不可（医療上必要）) | The doctor decided that, for medical reasons, it is better not to switch to a generic medicine. There is no special fee |
| Patient’s request (患者希望) | The brand-name medicine was prescribed by name at the patient’s request. The special fee applies |
When neither box is marked, the pharmacy can switch to a generic medicine. If you ask for the brand-name medicine in this case, the special fee applies. Even if “Patient’s request (患者希望)” is marked, if you listen to the explanation at the pharmacy and choose a generic medicine, there is no special fee.
Both doctors and pharmacists are supposed to explain to patients that they can choose a generic medicine and that a special fee may be charged.
When You Want a Generic Medicine
- When you want a generic medicine, tell the doctor or pharmacist and talk with them
- The Ministry of Health, Labour and Welfare provides a “Generic Medicine Request Sticker.” You can put it on your medicine notebook (お薬手帳, okusuri techo: a notebook that records the medicines you take) or similar and show it to the doctor or pharmacist. Putting it on is not required
- If it is hard to explain in Japanese, you may show the tables in this article or the Ministry of Health, Labour and Welfare’s leaflet when you talk with them
(Sources: Ministry of Health, Labour and Welfare “Generic Medicine Request Sticker”)
Troubles and Frequently Asked Questions
The color or shape of my medicine is different from usual. Is it a mistake?
Generic medicines may have different additives from the brand-name medicine, so the color or shape may be different. If you are worried, check with the pharmacist before you receive the medicine.
What if I do not want to switch to a generic medicine?
You can choose the brand-name medicine. However, if you choose, by your own preference, a brand-name medicine that has a generic, a special fee is charged. If you think there is a medical reason, talk to the doctor or pharmacist.
Is the special fee also charged for medicines bought at a drugstore (over-the-counter medicines)?
The special fee is a system for when you ask for the brand-name medicine among medicines prescribed by a doctor or dentist at a hospital or clinic (medicines covered by medical insurance). A list of the medicines covered is available on the Ministry of Health, Labour and Welfare page “About the Selective Treatment for Long-Listed Products.”
It is hard to talk about medicine in Japanese
First, talk to the pharmacist at the pharmacy where you receive your medicine. The Ministry of Health, Labour and Welfare’s leaflet also introduces places to contact about generic medicines, such as the “Drug Consultation Desk” (くすり相談窓口) of the Pharmaceuticals and Medical Devices Agency (PMDA). For places where you can get advice in foreign languages, also see When You Are Sick or Injured in Japan: The Basics of Hospitals, Ambulances, Medicine, Medical Insurance and Where to Get Advice.
(Sources: Ministry of Health, Labour and Welfare “Generic Medicines” leaflet (contact information), Ministry of Health, Labour and Welfare “About the Selective Treatment for Long-Listed Products”)
Primary Sources Used for This Article
- Ministry of Health, Labour and Welfare “About the Selective Treatment for Long-Listed Products”
- Ministry of Health, Labour and Welfare leaflet for patients “How Out-of-Pocket Costs Work When You Request a Brand-Name Medicine” (from June 2026)
- Ministry of Health, Labour and Welfare “Partial Revision of ‘Prescribing or Dispensing Long-Listed Products'” (March 27, 2026, Ho-I-Hatsu 0327 No. 9)
- Ministry of Health, Labour and Welfare “Promoting the Use of Generic Medicines and Biosimilars”
- Ministry of Health, Labour and Welfare “Generic Medicines” leaflet (March 2022 edition)
- Ministry of Health, Labour and Welfare “Generic Medicine Request Sticker”
This article is a translation of the original Japanese version.
