• Health

Biologic Medications in Japan

Biologic medications, also known as monoclonal antibodies, are becoming increasingly popular in Japan for the treatment of chronic diseases such as Crohn’s disease, asthma, and psoriasis. These medications, which are made from living cells, are designed to mimic the immune system and target specific proteins in the body that cause inflammation and disease.  Some common names of these medications are Humira, Stelara, Enbrel, and Remicade. 

Costs to the End User

In Japan, biologic medications can be extremely expensive, with the list cost of some medications at over ¥100,000 per month. Even with a 30% co-pay under national healthcare, this can be a significant financial burden for patients, especially those who require long-term treatment.  Monthly out-of-pocket costs over ¥30,000 per month could become a burden for ALTs.  It would be an unfortunate situation if a teacher were to come to Japan only to discover that the financial burden of their treatment made life in Japan unsustainable.

Insurance Scheme for High-Cost Medical Costs

To help offset the cost of high-cost medical expenses, Japan has implemented a system of “high-cost medical cost insurance.” Under this system, patients who require long-term treatment with biologic medications may be eligible for reimbursement for a portion of the cost of the medications. The amount of reimbursement varies depending on the patient’s income, medical history, and other factors, but it typically covers part of the co-pay cost of the medications.

Wait Period Between the Start of Treatment and Beginning of Coverage

There is often a wait period between the start of treatment and the beginning of coverage under the high-cost medical cost insurance program. This wait period can last several months and can be a significant barrier to access for patients who need treatment as soon as possible.  In the interim period, the patient would be expected to pay the full cost of treatment.

Difficulty of Finding a Doctor Who is Willing or Able to Prescribe the Biologic Medication

Another challenge for patients seeking biologic treatment in Japan is finding a doctor who is willing or able to prescribe the medications. Some doctors in Japan are not familiar with biologic medications, and some may be hesitant to prescribe them due to concerns about their safety and effectiveness. For patients arriving in Japan from overseas who are already undergoing treatment with biologic medications, this can be a significant obstacle, as they may need to find a new doctor who is willing to continue their treatment.  There is no centralized online list of doctors who can prescribe biologics, so it might require visiting several doctors before finding one who is willing to work with biologic treatment.

Things to keep in mind

If a prospective teacher is thinking of coming to Japan to teach English while being treated with a biologic medication, they should keep the following in mind:

  1. Research options: Before coming to Japan, it is important to research the availability and cost of biologic medications. This will help them determine if they can continue their treatment while in Japan and what the costs may be.
  2. Consult with doctor: They should consult with their doctor and ask for recommendations on how to continue their treatment in Japan. Their doctor may be able to provide them with information about local doctors who are familiar with biologic medications and who may be able to prescribe the medication.
  3. Check with insurance: They should also check with their insurance company to see if their medication can be prescribed for a whole year, so that they can bring a year’s worth of medications with them to Japan.  This would give them ample time to figure out where to continue treatment in Japan.
  4. Be proactive: It is important to be proactive and start researching their options as soon as possible, so they have enough time to make any necessary arrangements before coming to Japan.
  5. Consider alternative options: If the costs of biologic medications in Japan are too high, they may need to consider alternative treatment options, such as other drug therapy or lifestyle changes. They should consult with their doctor to determine the best course of action.

Final things to consider

It’s important to consider that all of the discussions with doctors will likely be conducted in Japanese. The company will not be able to provide an interpreter.  If a teacher’s Japanese level is not high enough to have a medical discussion, they might want to consider their options.  One possible solution is to go through an English-speaking international clinic for an initial consultation and referral to a local doctor.

For some prospective teachers, the better option may be opting out of teaching in Japan, given the high cost of treatment and barriers to receiving biologics.  It may be better for their health if they enjoyed Japan on a less-permanent basis, such as a short stay or study in Japan.  In that kind of situation, they’d be able to enjoy Japan without putting their health at risk.

For more information about healthcare in Japan, see our blog article here.