Telemedicine has finally entered Korea's regulatory framework, but critics say it remains a half-measure innovation. Authorities largely accommodated demands from the medical and pharmaceutical communities, maintaining the principle that telemedicine be conducted primarily for returning patients at neighborhood clinics, while restricting first-time consultations to patients' residential areas. With drug delivery blocked after telemedicine consultations, patients are forced to shuttle between pharmacies to fill their prescriptions — a phenomenon dubbed the "pharmacy runaround" — adding to user inconvenience. The government's sole fallback for maintaining its "no drug delivery" stance, the public late-night pharmacy system, is failing to serve its intended purpose.
According to industry data on Monday, roughly one in four patients who received telemedicine consultations was unable to obtain prescription medications, fueling concerns that the system is spinning its wheels. As a result, many physicians providing telemedicine services argue that drug delivery should be permitted. A report published by the Korean Medical Association's Research Institute for Healthcare Policy found that 52.4 percent of doctors said drug delivery should be allowed, noting that "if patients have to go out to pick up medications, there is no need for telemedicine in the first place, which defeats the very purpose of the system."
Behind the government's insistence on the drug delivery ban — despite criticism that it renders the system incomplete — lies strong opposition from pharmacists. The Korean Pharmaceutical Association has opposed drug delivery, arguing it violates the Pharmaceutical Affairs Act's "face-to-face sales" principle, that delivery without medication counseling could cause side effects, and that it could shrink the neighborhood pharmacy ecosystem. While the government treads carefully around the medical and pharmaceutical communities, telemedicine platform companies are facing threats to their survival. In March 2024, Doctor Now established its own pharmaceutical wholesaler to supply medications. The aim was to reduce pharmacy runaround inconvenience by enabling real-time pharmacy inventory checks based on inbound and outbound records and dispensing histories of medications supplied through the wholesaler. However, a bill dubbed the "Doctor Now Prevention Act" (an amendment to the Pharmaceutical Affairs Act) was introduced in the National Assembly to prevent platforms from owning pharmaceutical wholesalers, citing concerns over pharmacy dependence on platforms and possible patient inducement, referral, and kickbacks. With both the government and the pharmaceutical association supporting the bill, even this effort has been stymied.
The government has been operating the public late-night pharmacy system to address these issues, but critics say it too is not functioning properly. According to Ministry of Health and Welfare data obtained through the office of Rep. Seo Myung-ok of the People Power Party, a member of the National Assembly's Health and Welfare Committee, this year's budget allocated to public late-night pharmacies stands at 5.7 billion won. The public late-night pharmacy system was introduced to provide medication dispensing, sales, and professional medication counseling services from 10 p.m. to 1 a.m. the following day, when medical access is limited. Starting with 71 locations in 2022, the system has expanded to 240 locations this year. Operating costs for the three-hour overnight shift are set at 40,000 won per hour per pharmacist (60,000 won in population-decline areas), with the central and local governments each bearing 50 percent. Combined central and local government support from 2022 through this year has exceeded 18 billion won over five years.
However, there are clear limits to viewing public late-night pharmacies as an alternative medication supply network during vulnerable hours such as weekends and late nights. According to the Health Insurance Review and Assessment Service, a total of 25,446 pharmacies were operating nationwide as of March this year. Public late-night pharmacies account for just 0.94 percent, falling short of 1 percent. Not only are the absolute numbers too small, but regional disparities are also significant. An analysis by this newspaper of the locations and operating hours of all 240 public late-night pharmacies nationwide found that 117 — nearly half — are concentrated in the Seoul metropolitan area, including Seoul (34), Incheon (20) and Gyeonggi (63). Among the 89 population-decline areas where improved medical access is urgently needed, only 24 locations have public late-night pharmacies, including South Jeolla (6), North Jeolla (5), Busan (4) and South Chungcheong (3). In effect, three out of four population-decline areas are being left as "public blind spots" where obtaining medications during late-night hours is difficult.
Even among those in operation, only 175 locations keep to the original rule of opening from 10 p.m. to 1 a.m. the following day. About 40 locations, including 11 in Daegu and others in South and North Gyeongsang and South and North Jeolla, operate only from 9 p.m. to midnight, while the remaining 10 or so operate only from 8 p.m. to 11 p.m. In particular, nine of the 14 public late-night pharmacies designated in South Jeolla and five of the six in Jeju close at 11 p.m. Critics point out that despite the injection of public funds, tangible improvements in access are hard to expect at the local level. "The budget for public late-night pharmacies has increased, but due to limitations in operating hours and regional imbalances, the public's perceived benefit is low," Rep. Seo said. "Effective institutional improvements are needed so that telemedicine can achieve its original purpose."
