A system reform set to take effect in October 2024 will introduce an extra charge to patients who request brand-name drugs to which generic alternatives are available.  The extra charge is a fee corresponds to a quarter of the difference between the price of a brand-name drug and that of a generic drug.  For instance, if the price of a brand-name drug is 100 JPY per tablet and the generic drug is priced at 60 JPY per tablet, the difference in prices therebetween is 40 JPY, and in this case, patients will need to pay an extra charge of 10 JPY, which corresponds to a quarter of the 40 JPY difference.  The main purpose of this reform is to further promote the use of generic drugs, which will in turn contribute to the reduction of healthcare costs.

In Japan, on the other hand even where generic drugs are available, some patients prefer to use the brand-name drugs due to factors such as established usage records and reliability in the brand-name manufacturers.  On the other hand, as Japanese patients tend to be cost-sensitive, the reform is expected to encourage further the selection to generic drugs.  Consequently, brand-name manufacturers may need to strengthen the life cycle management of their drugs in Japan.  Examples of life cycle management include launching improved formulations (e.g., extended-release versions), developing combination therapies, securing formulation or combination therapy patents, all of which help maintain market competitiveness.

https://www.mhlw.go.jp/stf/newpage_39830.html (Japanese only)