Kobayashi Pharmaceutical will pay the medical bills of people who became ill after taking its troubled beni kōji fermented red rice supplements.

There have been hundreds of reports of illness, as well as some deaths, among those who took the Osaka-based drugmaker’s supplements, prompting a government investigation. On Friday, the company’s board of directors set up a third-party panel consisting of three legal experts to probe the company’s handling of the issue.

In a Thursday release, the company said it will reimburse costs incurred for medical treatment and transportation for those who needed medical attention after taking the firm's beni kōji supplements purchased after July 2023. Patients will need to provide a doctor's note in order to receive compensation.

It will also reimburse medical and transportation expenses for customers who went to a doctor to check on their health after consuming the supplements.

The company added that such reimbursement is an interim measure and that it would provide appropriate compensation should a causal relationship between the customers' health issues and the firm’s products be proven. It did not specify when that would be.

“At present, what caused (the health issues), how it happened, and whether there is a relationship between our products and kidney-related disorders, have not been clarified. However, we are working toward identifying the cause with the cooperation of the Ministry of Health, Labor and Welfare and the National Institute of Health Sciences,” the statement said.

Beni kōji, which is made by fermenting rice with red yeast, had been used in some of Kobayashi Pharmaceutical’s supplements and was also sold separately to other manufacturers as a raw ingredient.

An investigation conducted by the health ministry and the National Institute of Health Sciences has found at least two compounds not normally detected in the supplements. Kobayashi Pharmaceutical had previously detected puberulic acid, a highly toxic natural compound derived from blue mold, in its supplements.

Meanwhile, tracking down the problematic products has proven difficult due to the company’s extensive supply chain. A Teikoku Databank report indicates there were 4,822 companies who had purchased beni kōji from Kobayashi as of March, among which over one-third of them are food and drink manufacturers.

As of Wednesday, the health ministry had reported 257 hospitalizations and five deaths among people who took Kobayashi Pharmaceutical’s beni kōji supplements. A total of about 1,500 people who had visited a hospital over beni kōji-related concerns, the ministry’s data showed.

Taiwan, the only other region where similar cases of people getting ill after consuming beni kōji have been detected, had reported 58 "unexpected reactions" as of Thursday among people who took supplements using beni kōji made by either Kobayashi or other firms using Kobayashi’s ingredients, government data showed.

Common symptoms reported in Taiwan include a decline in renal function, blood in urine and lower back pain.