prescription meds

[gaijin86]

I started on daily presciption meds about 3 years ago (for cholesterol, bloodpressure, bloodthining, etc).

My local doctor here in Tokyo gives prescriptions for only *1 month* at a time (unless I have some good excuse like being overseas for 5 weeks). In Europe I think some/most countries give *dated prescriptions* for up to 6 months or even 1 year, to avoid wasting time and money with unnecessary doctor visits.

I understand that Japan now allows doctors to give prescriptions for up to 3 months, but when I asked my doc, she said her clinic only gives 1 month prescriptions. I think it is a nice little cash earner for the doc for doing nothing except saying お元気ですか, and giving a prescription. So I have to go to the clinic every month and pay 1400yen to say 元気です, and of course then pay the cost of the meds in the pharmacy.

Does anyone have a doctor who gives prescriptions for 3 (or 2) months?

[RetireJapan]

My ENT clinic will do six weeks (up to 2 months if I'll be abroad) but that's it.

And I take my allergy meds all year round, so eight visits a year for nothing

[Beaglehound]

Yeah, it’s a total pain, probably a symptom of ‘doctor knows best’. I am fortunate enough to have a doctor as a student who prescribes me three months worth of the couple of meds I need to take regularly.

For the OP, if you are not attached to your current doctor, perhaps look around for somewhere that will do three months for you. Or even threaten your current clinic that that is what you may do. You never know, their policy may become miraculously more flexible if patients vote with their feet.

Ben, antihistamines (if that’s what your allergy meds are) are markedly cheaper OTC in the U.K. I impose upon my sister to send some from time to time, anyone who visits me has to bring some as the price of admission, and I buy them when I am there.

[captainspoke]

I've been using the local uni hospital for quite a while, perhaps the same meds as you, gaijin86. While 90 days is the number bantered around, I think it's actually 91 (divisible by 7 for 13 weeks) so a patient could return in 13 weeks on the same day of the week to the same doc--since they're sometimes only available to see patients on certain weekdays.

So I get up to 91 days. It's only a guess, but it may be that it's a big hospital. I guess you'll have to dig up some local feedback--some other people local to you that have experience at other clinics/hospitals. While big places may give you 91 days' worth, IME the wait times to see the doc are too long--they can be really jammed up sometimes. I do visit a different place now and then, a clinic, and it can sometimes be almost walk in, like 5-10min of waiting and see the doc.



In my case the blood thinner is warfarin, which requires monitoring, which is getting to be a pain (in the arm) after a few years of blood work every 10-13 weeks. I have some notes for a coming appointment, switching to a DOAC among some other questions--I'll see what the fellow says in about a week.

[Nancy]

I can't remember what the code number is, but there is some kind of designation if you are being monitored for a chronic illness where you can have up to 3 months of medicine at once. I can't remember the code number. I don't know if only certain clinics or doctors can use this code or not..But I pay the same amount, 1400 for the visit, so possibly your doctor is using the chronic illness code designation.

[gaijin86]

>> For the OP, if you are not attached to your current doctor, perhaps look around for somewhere that will do three months for you. Or even threaten your current clinic that that is what you may do. You never know, their policy may become miraculously more flexible if patients vote with their feet.

Yes, I'm thinking of checking with a few junkanki clinics in the neighbourhood.
I'll avoid hinting anything more to the doc -- it would be awkward thereafter if I cant find any other doc, and have to stay with the present one.

[gaijin86]

... if you are being monitored for a chronic illness where you can have up to 3 months of medicine at once

Yep, high BP is chronic, but the monitoring is お元気ですか, let's check your bloodpressure (which I do myself anyway).

[TokyoWart]

I work in the Pharma industry Japan and this limited length of time for prescriptions is a longstanding feature of the Japanese healthcare system. In fact, when a drug is first launched a prescription can be for no more than 2 weeks (much to the dissatisfaction of my industry). I think this is partly to control costs (unused medication is a common problem everywhere) and diversion of medicine from the patient to others but it is also partly to control poly pharmacy (the tendency for Japanese to have a larger number of prescriptions at any one time than people in most other countries). I agree with posters who find this very inconvenient especially for relatively safe meds which require longterm use without interruption like cholesterol or hypertensive meds.

[captainspoke]

At least now, vs the 90s and before, the prescribing doc is no longer also the dispenser. (No conflict of padding their own pockets when prescribing.)

[Bubblegun]

Yes, My doc prescribes for two months ( they used to prescribe 3 months) and I think it is a way to milk the system as they also get to charge for each consultation, each bloody test, and isn't based on sound medical practice. The docs also get paid per patient, per visit, so it is in their interest to bring you back sooner rather than later. There was no real reason for the clinic to reduce my appointments from 3 months to two. Especially since I have been taking the same medication for near on 30 years. There was a time when I was going every 4 weeks. and I had to say Can I come every 3 months because i have to take a day off work. Suddenly it was possible.
Initially, this is a good thing especially after a diagnosis and treatment have begun, as it will us to Assess the condition, Plan the treatment, Implement the treatment plan, and then Evaluate it. (APIE) pick up side effects, and also allow for treatment changes. However, after several years of the same medicine, and no changes to your condition, then there should be absolutely no reason to actually bring a patient back who is stable, and tolerates their medication, and since most patients after years and years of taking medication, and managing their condition, can be trusted to come back to the clinic if there is a problem. So unlike the UK system where there is NO benefit to seeing patients more often accepted clinically, there is an incentive to bring patients back sooner in Japan and offer more treatments, and longer stays in hospitals. So each system has its benefits, and it's costs.

You might also notice there are extra charges for getting your prescription after certain times and on certain days.( another rip-off) If your not Japanese reading isn't that good, then patients may not know this.

I would say, shop around for a different doc who may do 2 or 3 months. Although you could say I monitor my BP every week, there are no side effects, and there is no real clinical reason to keep coming back so often. (But that can put their nose out of joint). It might be that the bigger the hospital the more likely they'll be busy and may ask you to come in 2 months than say a little clinic.