Wife and I are in the early phases of planning a move to Japan (probably Fukuoka area) for a couple of years. Fed up of corporate jobs and, just for a while, want to do some work where it doesn’t take 10 minutes to explain to people what you do. Many people who work in corporate roles will know this feeling!
For people with immune system disorders, I wanted to know what your experiences of accessing high cost biologic drugs were like (such as Infliximab, Adalimumab, Certolizumab, etc.) while living there.
I’ve discussed with my gastroenterologist and he’s agreed I can get a supply of around 6 months of injections to take abroad prescribed by him in the UK. However, it would be difficult to get more because the NHS works on maintaining a reasonable number of days spent residing in the UK.
I know the health insurance scheme covers 70% of costs but I apparently there is a scheme you can apply to for high cost drugs specifically. Even 30% of the cost of these drugs is still quite a bit. I think it brings the coverage up to 90% (correct me if I’m wrong). That’s only for these drugs – the rest of healthcare remains the standard 70%, apparently, which is completely fine with me!
Has anyone got any experience of accessing biologic drugs via this scheme for Crohn’s, arthritis, lupus, etc. Is it straightforward? Is there anything I should be aware of? I have done some research but there’s no substitute for real people’s experiences.
3 comments
* Infliximab 100mg is 60,233 while generics are 24,994.
* Adalimumab ranges from 26,297 for 20mg 0.2ml dose, up to 104,672 for 80mg 0.8ml dose. I don’t know what generics are called for this, but I don’t see any in the list.
* Certolizumab is 57,801 for 200mg 1ml dose. Generic only.
This is only what I could find in the list on [this page](https://www.mhlw.go.jp/topics/2023/04/tp20230401-01.html). You likely know the drugs a lot better than me, so feel free to have a browse, yourself.
I’m not sure about “high cost drugs” specifically, but there is a [maximum amount of medical care an individual can pay per month based on their income](https://www.ibmjapankenpo.jp/eng/member/benefit/expensive_a.html) (that is a specific provider’s website, but it should apply to all). I believe you can either apply in advance for your payments to stop at that amount, or apply for a refund if you already paid above that amount. Since this would be ongoing, it would fall under “The Cost-Sharing Maximum Amount will be reduced for frequent qualification of expenditures” on that linked page and the maximum would be 44,400 yen for an average salary.
>I can get a supply of around 6 months of injections
One thing to be aware of is that syringes are *highly* regulated here. So while you’ll probably be able to get your medications, you almost certainly won’t be able to get them in inject-at-home form.