Medication, Generic V Brand medication.

[adamu]

Is there a list or guide for items that can be claimed?

https://retirewiki.jp/wiki/Income_Tax#A ... Deductions

[Bubblegun]

I work in the pharmaceutical industry here in Japan. For what it's worth, there are some consumer and prescriber preferences here in Japan that create some of the differences you are discussing.

Regarding dosages and formulation delivery doses, there is a stronger preference in Japan than other countries to prescribe and use the lowest efficacious dose than you typically see in the EU or US. Two of the prescription drugs that my company invented and marketed worldwide had the most common marketed doses outside Japan as 10 mg (for drug A) and 20 mg (for drug B) while in Japan the most commonly prescribed doses were 5 mg and 10 mg. Sometimes that higher dose available overseas is not even approved in Japan but the prescriber/consumer preference is a bigger factor in my opinion.

In addition there is a preference for smaller pill sizes in Japan. Japan has some unusual formulation preferences, including the "dry syrup" granule formulations, but the small pill size can mean that a company uses a smaller pill size in Japan than elsewhere even when the dose delivered is identical. For most drugs you can put a lot of medicine in a small pill (100 mg of an active drug substance would look like the dust on the tip of your finger; most of any tablet is inactive incipients) but because of that desire to use smaller doses it doesn't surprise me that you found 6 tablets making 450 mg of ibuprofen in that example.

Regarding the availability of generic drugs, Japan has been in a serious generic drug supply crisis in recent years. There were widespread manufactuing standard (what we call "GMP") violations by a few of the prominent manufacturers (https://resource-allocation.biomedcentr ... 23-00441-z) and the industry still struggles. The generic drug business is not really profitable anywhere but the problem has been especially severe here. That is not so much an issue for ibuprofen or acetaminophen (paracetamol to you Europeans) but has been a problem for prescription drugs.

Thanks for that excellent explanation.
I have also noted that the Brufen in the UK mentioned above is 200mgs of the singular drug Brufen, but the popular brand in Japan has a mixture of two active drugs. One being 160mgs Brufen and the other 160mgs Acetaminophen. So sometimes the general public isn't comparing like with like. A mix of two drugs.
Another drug but a very similar name is Bufferin A and is aspirin.660mgs and 200 mgs hydrotalcite are used as an antacid, and may lead people to think it is similar to Ibuprofen but is a different drug altogether.

I agree with the powder drugs, which always puzzled me.
You're also right about the dosage and prescribing. We normally prescribe the lowest dosage first to see the effects and watch for side effects, or sequelae.
Then teeter up or down.( this would be prescription only from my experience). I think a major difference here compared to the UK/USA. Is we can walk into any clinic we want to in Japan, but in the UK, you don't have that freedom.You'll be lucky to see a GP within a week or two,if you want an appointment. So we are in some ways treated pretty well here as a service.

While we have diverged from prescription-only to OTC drugs the main point stands. Generic is cheaper, and just as effective as the brands. And as you mentioned some drug stores seem not able to get it while others are. (prescription-only medication). I hope that clarifies what I was trying to point out. Not the efficacy of OTC drugs or the price.

BTW Has anyone imported their medication from abroad just out of curiosity?

[Bubblegun]

Agree OTC drugs in Japan are horrifically expensive, but a least you can include them as part of medical expenses in your tax return...

Woah, wait, you can claim medical expenses on a tax return?

I had been seishain up until last month (started my own company since), so I am pretty unaware of what can/can't be claimed. Did not know that medical expenses are claimable!

Is there a list or guide for items that can be claimed? I asked my accountant, but she just gave a few vague/general items... and didn't include medical expenses! Would be helpful if there was a list somewhere.

I may be wrong on this point, but my understanding is, that you either claim the over-the-counter meds on tax, or you can put your national medical prescriptions on the tax, but not a mixture of both. That was my understanding. Maybe someone with better tax information can clarify.
But yes you can claim your expenses back up to about 12,000 yen for OTC meds.( off the top of my head)
Other medical expenses can be claimed up to a point 5% of income comes to mind.

[adamu]

I may be wrong on this point, but my understanding is, that you either claim the over-the-counter meds on tax, or you can put your national medical prescriptions on the tax, but not a mixture of both. That was my understanding. Maybe someone with better tax information can clarify.

It's linked from the above wiki page, but if you want it from the horse's mouth, page 39 onwards here: https://www.nta.go.jp/english/taxes/ind ... 023/12.pdf

[Bubblegun]

I may be wrong on this point, but my understanding is, that you either claim the over-the-counter meds on tax, or you can put your national medical prescriptions on the tax, but not a mixture of both. That was my understanding. Maybe someone with better tax information can clarify.

It's linked from the above wiki page, but if you want it from the horse's mouth, page 39 onwards here: https://www.nta.go.jp/english/taxes/ind ... 023/12.pdf

That pretty much confirms my initial thoughts.
You are eligible for this deduction if you make certain efforts as maintenance and promoting of health and prevention of diseases, and the expenses paid in 2023 to purchase certain medicines for you, your spouse or relatives living in the same household as you (see page 27) exceed 12,000 yen.
*The expenses required for maintenance and promoting of health and preventing disease (such as examination cost of medical check-up) are not subject to deduction.
This special treatment of the deduction for medical expenses by the self-medication tax system or the normal deduction for medical expenses (see page 39) is applicable either at the choice of the taxpayer.
Select one of them and perform calculations in the corresponding columns for calculations.

[cocacola]

Is there a list or guide for items that can be claimed?

https://retirewiki.jp/wiki/Income_Tax#A ... Deductions

Ah, great, thank-you very much, @adamu!

(And sorry for hijacking this thread)

[Deep Blue]

For stuff like painkillers I buy generic ibuprofen or paracetamol when I am in the UK, as little as 20p a pack… and the dosage is stronger than you get here in Japan too. Never buy OTC drugs in Japan if you can avoid it.

Edit; just checked the prices and they’ve doubled! But still a fraction of the price here

https://www.tesco.com/groceries/en-GB/p ... /257107498

https://www.tesco.com/groceries/en-GB/p ... /254434587

I am not sure where people get this DOSAGE IS stronger in the UK than Japan.(because the dosage is written on the back) and they are comparable.I think it's just people THINK something they have taken for years appears to be better. Or the person hasn't read the back of the box to check the dosage. Here is a typical cheap packet of Brufen from boots the chemist. and here is the very same drug in Japan.

If you look at the actual back of the pack you can see that a pack of Ibuprofen in the UK is 200 mg.
The exact same drug in the local drug store in Japan is, well you can see for yourself.
Also while this has been going around for years, that somehow Western drugs ( even though it is the same) is weaker is a rumour, and not based on pharmacology. If you want to confirm the dosage look at the back of the pack.
EG some drugs are 2.4 grams per day. and the doctor will prescribe 2.4 mg per day. The active drug is the same. Not any different.
The (Japanese drugs are weaker and American drugs are better) is probably based on Body mass and prescribing traditions/doctors' experience.

Here is how some other drugs are prescribed. EG. 1-2.5mgs per kilo. So if you're a person of a larger persuasion, then the doctor may give you something based on his experience. Which is probably based on the Japanese population. a person who is 100 Kg may be undermedicated if the doctor prescribes medication based on the person who is 75 kg.
Look at the back of the pack, and compare it to your favourite brand back home.
I might say that docs in Japan may be less aggressive, and start off with a lower dosage, and that maybe due to the size of the patient and the docs experience of treating people who are of lesser weight. I hope that makes sense.

Basically 200mgs in the UK/US is the same as 200mgs in Japan. But the effect might be different based on your BMI.
https://www.nibiohn.go.jp/eiken/kenkoun ... _en_02.pdf

Sorry this is just flat out wrong. The recommended dosage is lower in Japan and the active ingredient per pill reflects that. I also believe Japanese Docs are far more conservative at prescribing painkillers than Western Docs, though this later thought is based on my subjective personal experience over the past few weeks.

Unfortunately I’ve had to look into this a lot recently as I’ve been given the run around by the Japanese medical system and been in agony for two weeks before I finally convinced the fourth Doctor to prescribe proper prescription NSAID rather than the useless patches and OTC painkillers I was originally fobbed off with.

[Bubblegun]

For stuff like painkillers I buy generic ibuprofen or paracetamol when I am in the UK, as little as 20p a pack… and the dosage is stronger than you get here in Japan too. Never buy OTC drugs in Japan if you can avoid it.

Edit; just checked the prices and they’ve doubled! But still a fraction of the price here

https://www.tesco.com/groceries/en-GB/p ... /257107498

https://www.tesco.com/groceries/en-GB/p ... /254434587

I am not sure where people get this DOSAGE IS stronger in the UK than Japan.(because the dosage is written on the back) and they are comparable.I think it's just people THINK something they have taken for years appears to be better. Or the person hasn't read the back of the box to check the dosage. Here is a typical cheap packet of Brufen from boots the chemist. and here is the very same drug in Japan.

If you look at the actual back of the pack you can see that a pack of Ibuprofen in the UK is 200 mg.
The exact same drug in the local drug store in Japan is, well you can see for yourself.
Also while this has been going around for years, that somehow Western drugs ( even though it is the same) is weaker is a rumour, and not based on pharmacology. If you want to confirm the dosage look at the back of the pack.
EG some drugs are 2.4 grams per day. and the doctor will prescribe 2.4 mg per day. The active drug is the same. Not any different.
The (Japanese drugs are weaker and American drugs are better) is probably based on Body mass and prescribing traditions/doctors' experience.

Here is how some other drugs are prescribed. EG. 1-2.5mgs per kilo. So if you're a person of a larger persuasion, then the doctor may give you something based on his experience. Which is probably based on the Japanese population. a person who is 100 Kg may be undermedicated if the doctor prescribes medication based on the person who is 75 kg.
Look at the back of the pack, and compare it to your favourite brand back home.
I might say that docs in Japan may be less aggressive, and start off with a lower dosage, and that maybe due to the size of the patient and the docs experience of treating people who are of lesser weight. I hope that makes sense.

Basically 200mgs in the UK/US is the same as 200mgs in Japan. But the effect might be different based on your BMI.
https://www.nibiohn.go.jp/eiken/kenkoun ... _en_02.pdf

Sorry this is just flat out wrong. The recommended dosage is lower in Japan and the active ingredient per pill reflects that. I also believe Japanese Docs are far more conservative at prescribing painkillers than Western Docs, though this later thought is based on my subjective personal experience over the past few weeks.

Unfortunately, I’ve had to look into this a lot recently as I’ve been given the run around by the Japanese medical system and been in agony for two weeks before I finally convinced the fourth Doctor to prescribe proper prescription NSAID rather than the useless patches and OTC painkillers I was originally fobbed off with.

Thats fine. No worries. I'm sorry about how you were treated. However, I would like to say, that not all patients need the same level of medication. Maybe, you don't like the patches that is fine, they work fine for me.. And OTC meds may be lower than what a doctor directly can prescribe, and I recommend visiting the doctor as they can prescribe things you can't get OTC. Yes, some drugs do come in smaller dosages, and some in higher dosages.As they do in the other countries.
I still recommend that those who wish to buy at a cheaper rate request generic. These are Prescription only drugs. These are not OTC
I am suggesting that if you are happy to buy meds at the local drug store OTC, comparing box A with box B is a good idea. Just because it says it is specially formulated for period pain, or it says it is faster doesn't mean it is a better or a faster drug.

I wasn't comparing US drugs, European drugs, or any other countries' pharmacology policy, or dosage or efficacy, but about comparing white box A and Blue box B in Japan and the price differential. ( in Japan). Sorry if anyone thought I was.
Your right about dosages per pill. However, I was trying to compare Japanese Pills with Japanese pills.
Sorry if misunderstood anyones comments.

[Deep Blue]

No worries, I understand. Sorry I am a bit grouchy, I snapped my rib in half and for two weeks I almost passed out in pain everytime I coughed, got in or out of bed, laughed or tried to pass a bowel movement. At one point I was in so much pain I almost called an ambulance and was prepared to be checked in to hospital just so they could manage the pain and I could minimize movement.

Fortunately my wife talked me into trying a large hospital who gave me a CT scan as well as an X-ray and confirmed the rib was snapped, not just cracked. This Dr prescribed Zoltaren/Voltaren which finally let me manage the pain and I've managed to survive much easier the past ten days.

[captainspoke]

It's been quite a while since I've ordered anything from them, but iHerb is a pretty well known source for OTC from other places. (Amazon, too.)