Take Your Prescription to the Pharmacy Within 4 Days: The Special Fee for Brand-Name Drugs, and Bringing Medicine From Abroad

When you need medication at a clinic or hospital in Japan, in most cases you are not handed the medicine on the spot; instead you receive a piece of paper called a prescription (処方箱, shōhōsen). You take this to a pharmacy in town and receive the medicine from a pharmacist — that is the basic flow. The Ukrainian-language explanatory material the Ministry of Health, Labour and Welfare (MHLW) prepared for medical institutions also states: “As a rule, except in special cases, medicines are prescribed as outpatient (off-site) prescriptions.”

Below, based on the law (via the e-Gov law search database) and MHLW guidance, we explain the prescription’s validity period, how to choose a pharmacy, the medication notebook, the “special fee” for choosing an original brand-name drug, and the rules for bringing medicine into Japan from Ukraine or another country. This was confirmed in September 2026. This article does not cover which medicine to use, how to take it, or how to deal with symptoms — please consult a doctor and pharmacist about those.

A Prescription Is Valid for 4 Days, Including the Day It Is Issued

The “Rules on the Treatment of Patients at Insurance Medical Institutions and by Insurance Physicians” (保険医療機関及び保険医療養担当規則), which set out the rules for insured medical treatment, state that a prescription’s period of use is “within four days, including the day of issue” (Article 20, item 3-a). A prescription received on a Monday must be taken to a pharmacy by Thursday. This does not apply when a doctor recognizes special circumstances, such as a long trip. A pharmacy cannot dispense medicine against an expired prescription, so you would need to see a doctor again.

The MHLW’s Ukrainian-language material (“Explanation of Outpatient Prescriptions,” June 2022 edition) also explains that, within the validity period, you can receive medicine at any pharmacy in Japan; that someone acting on your behalf can take the prescription and receive the medicine; and that amounts paid at the pharmacy also qualify for the medical expense deduction (医療費控除), so you should keep your receipts.

The same rules also provide for a “repeat prescription” (リフィル処方箱, rifiru shōhōsen). Only when a doctor has approved it, a single prescription can be used up to 3 times; from the second use onward, it must be taken to the pharmacy within 7 days before or after the date the previous supply of medicine was due to run out (Article 20, item 3-b). Some medicines cannot be prescribed this way, and it is the doctor who decides whether to make a prescription repeatable.

You Can Choose Your Own Pharmacy

The same rules provide that, when a doctor issues a prescription, they must not instruct the patient to receive the medicine at a specific pharmacy (Article 19-3). It can be a pharmacy near the hospital, or one near your home or workplace. The Guidebook on Living and Working (生活・就労ガイドブック), Japanese edition, 8th edition, February 2026, supervised by the Immigration Services Agency of Japan (ISA), explains that at a pharmacy a pharmacist prepares the medicine based on the doctor’s prescription and hands it over after explaining how to take it (medication guidance), and that at a drugstore (ドラッグストア) you can buy medicines that do not require a prescription (OTC drugs), but drugstores do not accept prescriptions. It recommends consulting a pharmacist at a pharmacy or drugstore if you have questions about medicine.

At the pharmacy counter, just as at a hospital, you show proof of insurance (a My Number Health Insurance Card or certificate of eligibility, etc.). How to show it is covered in our article on preparing before a hospital visit in Japan.

The Medication Notebook: All Your Medicine Records in One Book

The medication notebook (お薬手帳, okusuri techō) is a notebook that records, in chronological order, the medicines you have received. MHLW materials explain that it helps you manage your own health, and that when a doctor or pharmacist checks it, it helps avoid problems from drug interactions and side effects. Under the medical fee schedule rules, a “notebook” is one that has spaces to record the patient’s name and contact details, history of allergies and side effects, major past illnesses, and the contact details of the pharmacy the patient usually uses.

There is also an electronic version of the medication notebook, recorded through a smartphone app. According to the MHLW, if the app can link with Mynaportal (マイナポータル), then with the person’s consent, records of medicine dispensed at medical institutions and pharmacies can be retrieved from Mynaportal.

Showing the Notebook Can Lower What You Pay

Payment at the pharmacy includes, besides the cost of the medicine itself, a fee for the pharmacist’s explanation and record-keeping (the medication management and guidance fee, 服薬管理指導料). According to MHLW materials on the FY2026 revision of medical fees, if you bring a prescription to the same pharmacy again within, as a rule, 3 months and show your notebook, the fee is 45 points; otherwise it is 59 points. These point values are unchanged from before the revision. The patient pays their co-payment share (in most cases 30%) of the amount calculated from these points. The points and conditions are reviewed each time medical fees are revised.

Generic Drugs, and the “Special Fee” for Choosing an Original Brand-Name Drug

A generic drug (後発医薬品, kōhatsu iyakuhin, also called ジェネリック医薬品) is a drug approved as having the same active ingredient, amount, method of use, dosage, and indications and effects as a drug approved earlier (the original brand-name drug, 先発医薬品), under the definition in Article 20, item 2-d of the Rules on the Treatment of Patients at Insurance Medical Institutions and by Insurance Physicians. It is generally priced lower than the original brand-name drug.

Since October 1, 2024, when a patient chooses, without medical necessity, to use an original brand-name drug for which a generic exists (a “long-listed drug,” 長期収載品), a system has been in place under which they pay a “special fee” (特別の料金) in addition to their usual co-payment (the “patient-choice treatment for long-listed drugs,” 長期収載品の選定療養). Initially this was one-quarter of the price difference between the original brand-name drug and the generic; from June 2026 it became one-half.

According to MHLW guidance, the special fee is subject to consumption tax, and when more than one generic exists, it is calculated against the difference from the most expensive generic. The special fee does not apply in the following cases:

• A doctor or other medical professional has determined there is a medical need to use the original brand-name drug (marked on the prescription in the “Substitution not permitted (medically necessary)” field, 変更不可（医療上必要）)
• The pharmacy or other dispenser has no generic in stock and has no choice but to dispense the original brand-name drug

The March 2026 notice requires doctors and pharmacists to explain to patients that they can choose a generic and that choosing the original brand-name drug may incur the special fee, and asks pharmacies to also confirm the patient’s preference.

Bringing Medicine Into Japan From Ukraine or Another Country

In Japan, importing medicine for sale requires national approval or a license. If you import medicine for your own use (including bringing it in as carry-on baggage when entering the country, or having it mailed to you from abroad), you are, as a rule, required to obtain confirmation from a Regional Bureau of Health and Welfare (地方厚生局); but as an exception, up to the quantities below, customs confirmation alone is enough to import it. This is based on the MHLW page “On the Personal Importation of Medicines and Other Products” (医薬品等の個人輸入について).

If you exceed these quantities, you need to apply in advance to a Regional Bureau of Health and Welfare, obtain an “Import Confirmation Certificate” (輸入確認証, yunyū kakuninshō), and present it to customs. If you have a doctor’s prescription or written instructions, you may in some cases be able to import more than the set quantity. According to the MHLW, this document used to be called a “Drug Control Certificate” (薬監証明, yakukan shōmei), but it was replaced by the Import Confirmation Certificate from September 1, 2020, following a revision of the Act on Pharmaceuticals and Medical Devices.

You may import only what you will use yourself; you cannot sell or give the medicine to someone else, and importing a combined supply for family or friends is not permitted either. Guidance from the Kanto-Shin’etsu Regional Bureau of Health and Welfare explains that if the delivery address is somewhere other than your home (such as your workplace or held at a post office), it is harder for the import to be recognized as for personal use, and you will need a confirmation document to present to customs.

Drugs Regulated by Other Laws

Individuals are prohibited from importing medical narcotics, psychotropic drugs, or pharmaceutical raw materials for stimulant drugs, except when the person to whom they were prescribed by a doctor brings them in personally as carry-on baggage when entering the country; violations are punishable. You cannot have someone other than yourself bring them in, nor order them by international mail. According to MHLW guidance, entering the country with medical narcotics or pharmaceutical raw materials for stimulant drugs requires the permission of the head of a Regional Bureau of Health and Welfare, regardless of quantity. For medical psychotropic drugs, an Import Confirmation Certificate is required in advance if you bring in more than a 1-month supply or an injectable form.

Which category a medicine prescribed in Ukraine falls into under Japanese law depends on its ingredients, and this article cannot determine that. Before bringing medicine into Japan, contact a Regional Bureau of Health and Welfare of the MHLW (for psychotropic drugs and the like, the ministry’s Enforcement and Narcotics Control Division). The ministry’s page also lists medicines for which confirmation such as a prescription is required regardless of quantity, because using them without a doctor’s prescription is considered to carry a significant risk of harm to health.

Materials Available in Ukrainian

Ukrainian-language materials were added to the MHLW’s “Multilingual Explanatory Materials for Foreign Nationals” (外国人向け多言語説明資料) in July 2022. They are written side by side with English and Japanese, and include, besides the “Explanation of Outpatient Prescriptions” introduced above, a treatment application form, a medical questionnaire, and more. The ministry provides these for medical institutions in Japan, but as a rule allows the page to be freely linked to. The Ukrainian-language edition of the Guidebook on Living and Working (7th edition, March 2025) also has sections on pharmacies and drugstores.

As of September 2026, we have not confirmed a public counter that offers pharmacy consultations in Ukrainian. General-life counters where you can consult in Ukrainian are covered in our article on consultation counters, and how to use translation apps is covered in our article on translation apps and interpreters. For a sudden illness or injury, call 119 (see our article on 110 and 119).