Comparison of Emergency Contraceptive Pill Regulations in Other Highly Developed Countries and Policy Recommendations for the Deregulation in Japan

Abstract

Emergency contraceptive pills with levonorgestrel are currently available with a prescription in Japan. Due to public demand, a change in regulations is under consideration. In this paper, we assess the regulations concerning emergency contraceptive pills in Japan and compare them to those of other highly developed countries. Based on this information, we make recommendations on the necessary policy changes and additional measures to implement the switch of emergency contraceptive pills to over-the-counter (non-prescription) status in Japan. In all countries considered in this paper (except for Japan), levonorgestrel emergency contraceptive pills are available without a prescription. We therefore propose levonorgestrel emergency contraceptive pills to be classified as an over-the-counter drug for women over the age of 16, requiring an in-person consultation with the pharmacist. This corresponds to the Japanese classification of“drugs requiring special instruction” (youshidou-iyakuhin). We also propose a change in drug regulations that would allow such drugs to stay within that category. Prices for levonorgestrel emergency contraceptive pills range from free to up to 50 USD in the countries studied; however, in Japan, where the physician’s consultation fee is included, prices can be up to 183 USD. To reduce the financial burden for patients, we therefore recommend the implementation of a policy which would allow patients to have the medication subsidized by health insurance. Furthermore, we propose additional measures pertaining to sex education of the public and pharmacists, updating of pharmacy facilities and cooperation with nearby clinics.