98% Agreement on 'Emergency Contraceptive Purchasable at Pharmacies without Prescription' in Japan
Measures to allow the purchase of emergency contraceptives at pharmacies in Japan without a prescription are progressing rapidly.
Despite opposition from the medical community, a majority of the public supports this, increasing the likelihood of social consensus.
Japan Extends Trial Sales of Emergency Contraceptives
The Japanese Ministry of Health, Labour and Welfare is considering extending the trial sale of emergency contraceptives at pharmacies, which started in November 2023, until early 2026. Initially, this project was slated to continue until March 2024, but was extended to March 2025 due to a lack of data. Accordingly, the ministry has begun recruiting private operators to carry out trial sales.
Emergency contraceptives are drugs that can prevent pregnancy when taken within 72 hours after intercourse. The sooner they are taken, the more effective they are, and they are primarily used to prevent unwanted pregnancies after contraceptive failure or sexual assault.
This measure is interpreted as an effort to increase the accessibility of emergency contraceptives and protect women's rights in Japan. Future developments are being closely monitored.
Currently available emergency contraceptives in South Korea include Norlevo Tablets (Levonorgestrel), Postinor Tablets (Levonorgestrel), and Ella Tablets (Ulipristal Acetate).
Norlevo and Postinor, which contain Levonorgestrel, are effective when taken within 72 hours after intercourse. In contrast, Ella, which contains Ulipristal Acetate, remains effective up to 120 hours, or 5 days.
These emergency contraceptives can be a useful option in unavoidable situations.
Current Situation of Emergency Contraceptive Purchases in Japan
Currently, emergency contraceptives in Japan are classified as prescription drugs, necessitating a doctor’s consultation and prescription to purchase them. As a result, health insurance does not apply, and combined treatment and medication costs can reach between 10,000 to 20,000 yen (approximately 98,000 to 196,000 won), causing economic burdens.
Due to these regulations, individuals living in remote areas or on hospital closure days find it difficult to obtain the medication. Additionally, the psychological burden of explaining personal circumstances to a doctor is significant, leading to continuous demands for the ability to purchase emergency contraceptives at pharmacies without a prescription.
Currently, through trial sales, a system is in place where emergency contraceptives can be purchased after consultation with pharmacists at 339 pharmacies across the country. In this case, the price has decreased to around 7,000 to 9,000 yen (approximately 68,000 to 88,000 won), but it remains a burden for many.
This highlights an increasing voice for the need for changes to improve access to emergency contraceptives.
Reasons for the Medical Community's Opposition?
The medical community in Japan remains cautious regarding the issue of switching emergency contraceptives to over-the-counter status. The Japan Society of Obstetrics and Gynecology expressed concerns during review meetings of the Ministry of Health, Labour and Welfare, pointing out three main issues.
The first is the potential for drug trafficking. If emergency contraceptives become easily purchasable at pharmacies, there is a possibility that they could be illegally circulated, leading to social problems.
The second is the concern of misuse in sexual crimes. If emergency contraceptives are easily obtainable, there is a risk that perpetrators could administer the drug to victims without their consent. This could result in serious harm to victims.
Finally, there is a concern about evading male contraceptive responsibility. Contraception is a shared responsibility between men and women, but if emergency contraceptives become easy to obtain, some men might become complacent about contraception. Given these points, a cautious approach is necessary.
Global Regulations on Emergency Contraceptives
Currently, in about 90 countries worldwide, emergency contraceptives can be purchased without a prescription at pharmacies. In particular, in countries with fewer regulations than Japan, prices are set at less than half of those in Japan, making them more accessible.
Discussion on the switch of emergency contraceptives to general medicine in Japan has been ongoing since the drug was approved as a medical prescription in 2011. However, concerns about misuse in sexual crimes and trafficking have constantly postponed these discussions.
In 2020, discussions resumed with the inclusion of a policy to consider retail sales under certain conditions. In 2021, the government's position changed, and it was decided to continue reviewing the situation considering both domestic and international circumstances. Notably, by the end of 2022, about 46,000 opinions were submitted in a public consultation conducted by the Ministry of Health, Labour and Welfare, with around 98% supporting retail sales.
This situation is expected to be an important turning point in enhancing access to emergency contraceptives in Japan.
Increasing Demands for Quick Decisions from the Japanese Government
Voices of criticism are rising regarding the prolonged discussions. In February, a representative from the Japan Pharmaceutical Society urged the government for a decision during the Ministry of Health, Labour and Welfare review meeting, asking, "Is further investigation still necessary?"
It is now becoming a significant concern whether the Japanese government will respond to public demands with a swift decision. As emergency contraceptives are currently on trial sale in Japan, there is a high possibility of transitioning to full general medicine through additional research and evaluation.
Is It Possible for South Korea to Transition Emergency Contraceptives to Over-the-Counter Status?
Currently, in South Korea, emergency contraceptives are classified as prescription drugs, meaning a doctor's prescription is required for purchase. Similar to Japan, there have been discussions about transitioning emergency contraceptives to over-the-counter status due to opposition from the medical community and concerns about sexual crime misuse, but no changes have occurred yet.
However, if Japan transitions emergency contraceptives to general medicine, it is highly likely that discussions will become active again in South Korea. Therefore, it is essential to monitor how the discussions to improve access to emergency contraceptives in South Korea will progress in the future.
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