Self-Medication Culture and OTC Switch in GermanyComparison and Future Outlookpublic awareness and the rule prohibiting simultaneous use with general medical expense deductions. Despite these efforts, the number of new approvals remains limited. Key challenges include the high development costs for companies, strict safety evaluations, and insufficient public understanding of self-medication. Thus, while institutional transparency has improved, Japan’s OTC switch policy still faces hurdles to achieving broader social adoption.medicines must be paid for fully by the customer and are not covered by statutory health insurance. This framework naturally encourages citizens to distinguish between symptoms that can be self-treated and those requiring a physician’s care. Germany also has a long-standing and liberal tradition of switching prescription drugs to OTC status. Between 2000 and 2016, over 30 active pharmaceutical ingredients were reclassified, with roughly half categorized as “innovative switches” that opened new therapeutic fields. The country’s switch process, managed by the Federal Institute for Drugs and Medical Devices (BfArM), emphasizes three principles: safety, self-diagnosability, and low risk of misuse. Applications are reviewed by a committee composed of experts and citizen representatives, ensuring high transparency and public trust. This integration of systemic regulation and cultural practice has made Germany one of the most advanced countries in the world in terms of self-medication. For Japan to further advance self-medication, it will be essential not only to improve legal frameworks but also to strengthen collaboration with pharmacists, enhance health education, and foster behavioral change among citizens. Building a culture in which individuals feel confident managing minor ailments through appropriate guidance will be key to balancing accessibility, safety, and sustainability in Japan’s healthcare system. Under this system, individuals who undergo certain health checkups or vaccinations can deduct from their taxable income any amount exceeding 12,000 yen spent annually on eligible switch OTC medicines (up to a ceiling of 88,000 yen). The policy aims to reward those who take responsibility for their own health and reduce unnecessary doctor visits. However, uptake has been limited—only about 50,000 people utilized the system in fiscal 2024—due to low In contrast, self-medication has become deeply embedded in daily life in Germany. Unlike Japan’s system of low out-of-pocket medical costs, Germany’s healthcare structure involves higher co-payments and longer waiting times for physician consultations. As a result, it is culturally common for people to first consult a pharmacist at a local Apotheke for minor ailments such as colds, headaches, or digestive problems. Pharmacists, who are required to be present at all pharmacies, provide personalized advice on drug selection and usage, functioning as the frontline of primary care. OTC medicines in Germany can only be sold in licensed pharmacies, not in supermarkets or convenience stores. This ensures that even self-medication occurs under professional supervision. Pharmacists engage directly with consumers, assess their condition, and recommend appropriate medicines—a structure that ensures both accessibility and safety. According to the ABDA (Federal Union of German Associations of Pharmacists), all non-prescription Both Japan and Germany aim to promote self-medication as a means to improve healthcare efficiency and reduce public expenditure, yet their pathways differ significantly. Japan’s approach has been institution-driven, focusing on regulatory reforms and tax incentives to create a framework for self-care. In contrast, Germany’s success stems from a cultural foundation built on pharmacy-centered healthcare and citizens’ awareness of responsible medicine use.8
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