Re: Medication, Generic V Brand medication.
Posted: Wed Aug 14, 2024 6:15 am
Personal Finance for Residents of Japan
https://retirejapan.com/forum/
Thanks for that excellent explanation.TokyoWart wrote: ↑Wed Aug 14, 2024 5:56 am 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.
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.cocacola wrote: ↑Wed Aug 14, 2024 5:32 amWoah, 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.
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.pdfBubblegun wrote: ↑Wed Aug 14, 2024 6:47 am 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.
That pretty much confirms my initial thoughts.adamu wrote: ↑Wed Aug 14, 2024 6:57 amIt'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.pdfBubblegun wrote: ↑Wed Aug 14, 2024 6:47 am 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.
Ah, great, thank-you very much, @adamu!
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.Bubblegun wrote: ↑Wed Aug 14, 2024 1:08 amI 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.Deep Blue wrote: ↑Tue Aug 13, 2024 8:48 pm 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
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
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.Deep Blue wrote: ↑Wed Aug 14, 2024 8:25 amSorry 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.Bubblegun wrote: ↑Wed Aug 14, 2024 1:08 amI 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.Deep Blue wrote: ↑Tue Aug 13, 2024 8:48 pm 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
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
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.