It’s taken years to wind its way through the approval process. But it’s finally happened. As of two days ago, women in Japan have access to a key form of contraception – no questions asked. The move comes after years of debate and opposition, including from within Japan’s male-dominated medical community.
The details
Levonorgestrel, a.k.a. the morning-after pill, is a hormonal medication that prevents an egg from being released, which can prevent unwanted pregnancy within 72 hours of unprotected sex. The medication is 81% effective at preventing pregnancy. It’s sold in the US and other countries under the brand name Plan B.
It’s been available with a prescription in Japan for years. That created barriers, especially for vulnerable women and teens, to securing the medication.
As of February 2nd, a form of levonorgestrel is now available over the counter. Sold by Daiichi Sankyo Health Care under the brand name Norlevo (ノルレボ), a single pill costs 7,480 yen ($48). Women must sign a checklist and receive a consultation from a pharmacist before receiving it. There are also various restrictions, e.g., it can’t be sold to anyone other than the woman who intends to use it (i.e., no husband/boyfriend purchases), and it can’t be sold to pregnant people.
It’s also not available everywhere. Only pharmacists trained to dispense it and stores that can adequately protect women’s privacy are approved to sell it. Japan’s Ministry of Health, Labour and Welfare (MHLW) publishes an Excel spreadsheet of the stores that retail it. By our count, it’s available at over 22,000 stores across the country.
On the flip side, any woman can acquire the pill after filling out the form. There is no age restriction, and minors don’t need parental consent to purchase it.
Three years from trial to full OTC approval
According to a survey by Daiichi Sankyo, 1 in 5 women say they’ve experienced times where contraception has failed, or they couldn’t use contraception for some reason. That makes easy access to this time-limited medication a godsend for many in Japan.
Despite the need for easier access, approval hasn’t come easily. Advocates have been fighting for OTC access since at least 2020, when Unseen Japan started writing about this issue.
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In 2023, Japan began a limited trial program, selling the pill at select pharmacies nationwide. The original goal was for a national rollout in 2024 – a goal that’s finally been realized two years later.
“Women can’t be trusted”
This development comes several months into the tenure of Japan’s first female Prime Minister, Takaichi Sanae. However, Takaichi and her party had little to do with this victory.
As Constitutional Democratic Party (CDP) member Gotoh Sakiko points out, the Liberal Democratic Party (LDP) was lukewarm on making the morning-after pill easier to acquire. Only 39% of those polled approved of it, with 47% opposed. By contrast, 77% of the CDP approved (and the party made easier access a part of its platform). Other liberal parties, such as the Japan Communist Party (89%) and Reiwa Shinsengumi (98%), overwhelmingly supported it.
OTC approval faced opposition from many conservative groups, who argued that the last thing a country with a rapidly declining population needs is easier access to contraceptives. Even the head of Japan’s OB-GYN association (a man, naturally), said that Japanese women weren’t “educated” enough about sex to use the pill responsibly.
Greater availability will help balance out the uneven state of contraception in Japan. In contrast to other countries, where many women use birth control pills to stave off unwanted pregnancy, a majority of women in Japan rely on male condom use, as female birth control is expensive and not covered by insurance.
At nearly $50 a pill, Norlevo isn’t exactly cheap. But I wager many will find the cost worth the peace of mind.
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Sources
性行為後に飲む緊急避妊薬「ノルレボ」、2日から薬局で販売へ 薬局で服用が必須、販売しているか事前に確認を. NTV News
