Higher "special fee" for long-listed products (originator drugs with a generic) under selected medical treatment — from a quarter to a half of the price difference (in force 1 June 2026)
Source material is a Japanese government announcement (in Japanese); this page is a summary.
From 1 June 2026, the "special fee" charged under selected medical treatment on top of the usual co-payment, when a patient chooses a "long-listed product" — an originator drug that has a generic — by preference rather than for a medical reason, rises from a quarter to half of the price difference between the originator and the generic.
Key facts
| Date in force | 1 June 2026 (Ministry of Health, Labour and Welfare Notification No. 116, issued 27 March 2026) |
|---|---|
| What it covers | Originator drugs that have a generic = long-listed products (長期収載品) |
| Special fee | Half of the price difference between the originator and the generic (previously a quarter, as set when introduced on 1 October 2024) |
| Worked example | Originator 100 yen, generic 60 yen → half of the 40 yen difference = 20 yen (separate from the usual 10% to 30% co-payment) |
| Consumption tax | The "special fee" is taxable, so consumption tax is added |
| Exclusions | Cases where a medical need is recognised, and cases where supplying the generic is difficult because of stock levels or similar reasons |
| Responsible office | Medical Economics Division, Health Insurance Bureau, Ministry of Health, Labour and Welfare |
Last checked:
Japan's Ministry of Health, Labour and Welfare has raised the "special fee" charged under selected medical treatment when a patient chooses an originator drug that has a generic (a long-listed product) by preference rather than for a medical reason, with effect from 1 June 2026. When the arrangement was introduced on 1 October 2024 the special fee was a quarter of the price difference between the originator and the generic, but a notification of 27 March 2026 (Ministry of Health, Labour and Welfare Notification No. 116) changed it to half of the difference from 1 June. For example, if the originator costs 100 yen per tablet and the generic 60 yen, you pay half of the 40 yen difference — 20 yen — as a special fee, on top of the usual 10% to 30% co-payment (the special fee is taxable, so consumption tax is added). Cases where there is a recognised medical need, or where supplying the generic is difficult because of stock levels or similar reasons, are excluded.
Background — why this change
A long-listed product (長期収載品) is an originator drug for which a generic with the same active ingredient exists. If a patient asks for the originator without a medical need, the drug falls under selected medical treatment and the patient pays a "special fee" on top of the usual insurance co-payment (introduced on 1 October 2024). The increase in the special fee ratio from a quarter to a half was decided in Ministry of Health, Labour and Welfare Notification No. 116 of 27 March 2026, following discussion and reports by the Health Insurance Committee of the Social Security Council and the Central Social Insurance Medical Council, and applies from 1 June.
Summaries below are factual notes based on government announcements and primary sources — not evaluations or opinions.
Summaries reflect national-level programs. Municipal (city/ward/town) programs may differ — confirm with the official desk before applying.
FAQ
When does it apply from?
From 1 June 2026 (Ministry of Health, Labour and Welfare Notification No. 116, issued 27 March 2026). The arrangement itself was introduced on 1 October 2024, and at that time the special fee was a quarter of the price difference.
How much is the special fee?
From 1 June 2026 it is half of the price difference between the originator and the generic (previously a quarter). For example, if the originator costs 100 yen and the generic 60 yen, it is half of the 40 yen difference — 20 yen — with consumption tax added. You pay it on top of the usual 10% to 30% co-payment.
Does this apply to every originator drug?
No. It applies to originator drugs that have a generic (long-listed products). Cases where a medical need is recognised, and cases where supplying the generic is difficult because of stock levels or similar reasons, are excluded and no special fee arises.