Morning-after pill finally available over the counter in Japan

The morning-after pill is finally available in Japan after years of campaigning and a trial roll-out in 2023.

The pill (NorLevo, made by ASKA Pharmaceuticals) is available to purchase over the counter since February 2 at pharmacies in Japan, priced ¥7,480 per pill. A prescription is not required but you must buy the emergency contraceptive pill in person (no online sales allowed).

It’s needed in a country where unprotected sex is arguably the norm (as the number of shotgun marriages attests, as does the recent prevalence of syphilis), much to the chagrin of Japan’s superb condom manufacturers, who produce some of the world’s thinnest sheaths.

Conservatives had argued that over-the-counter availability would encourage women to have more unprotected sex and not keep a pregnancy.

This is a straw man argument, since abortion is already common (and the abortion pill is already available, albeit only with partner consent), and unexpected and unwanted pregnancies are not going to solve the population crisis.

For years, campaigners had argued that the case against providing women with easy access to the morning-after pill was dominated by male thinking. (And indeed, lawmakers were surprisingly fast to approve access to Viagra in the 1990s.)

Japan was an outlier in not allowing full access to the morning-after pill, which is available in around 90 countries but previously in Japan required a doctor’s prescription from certain specific clinics. Given that the morning-after pill’s effectiveness is limited to around 72 hours after intercourse, making an appointment and getting to a particular clinic was not a realistic way to offer genuine access. Over-the-counter purchases of NorLevo are now available at 5,445 pharmacies and drugstores in Japan.

There are still some caveats about the new availability of the morning-after pill. Other than its expense, which is more than many over-the-counter drugs, and may be prohibitive to women in certain economic brackets, it cannot be purchased ahead of time and kept for an emergency at home. Once purchased in person, it must be consumed in front of the pharmacist (who may be male). In addition to the obvious breach in privacy that this constitutes, the condition limits its NorLevo’s purchase only to an actual instance when you think intercourse has resulted in a pregnancy.