One in four users of telemedicine platforms — which filled medical gaps during the COVID-19 pandemic and the recent standoff between doctors and the government — failed to obtain their prescription drugs even after receiving a prescription.
According to internal data from telemedicine platform "My Doctor," obtained by Seoul Economic Daily on the 21st, the medication receipt rate among telemedicine users stood at just 73.28% between March 2024 — when the government fully permitted the telemedicine pilot program to address the medical vacuum caused by trainee doctors' departure — and March of this year. This is the first time such figures have been made public.
The rate of cases in which patients either waited more than 12 hours to receive medications or failed to receive them at all after using telemedicine on holidays or during late-night hours reached 36.5%, more than 10 percentage points higher than the 25.6% recorded during weekday daytime hours. The average time required to receive medications following telemedicine consultations on holidays and late nights was 8.87 hours, more than three hours longer than the weekday daytime average of 5.76 hours. The delays occur because patients must pick up medications in person, as drug delivery is prohibited even after telemedicine consultations.
Experts are voicing concerns that usage could decline further when the amended Medical Service Act takes full effect in December. The revision imposes stricter regulations than the pilot program, allowing initial telemedicine consultations only at hospitals in the patient's residential area and capping the monthly proportion of telemedicine consultations within a hospital's total patient care. In recent discussions on subordinate legislation, proposals to restrict medications and prescription durations allowed through telemedicine — citing concerns over drug misuse — were reportedly also raised. "During the pilot program, many hospitals offered 24-hour telemedicine services, but since the Ministry of Health and Welfare announced it would limit telemedicine's share, the proportion of consultations during early morning hours has dropped significantly," said Sun Jae-won, CEO of My Doctor.
The government's insistence on maintaining the ban on drug deliveries — even at the cost of criticism that the system is only half-functional — stems from opposition by pharmacists. The Korean Pharmaceutical Association opposes drug delivery, arguing that it violates the "face-to-face sales" principle under the Pharmaceutical Affairs Act, that delivering medications without in-person consultation on usage could cause side effects, and that it could erode the neighborhood pharmacy ecosystem. While the government treads carefully around the medical and pharmaceutical communities, telemedicine platform companies find their very survival under threat.
The government operates a public late-night pharmacy program to address such problems, but critics say even this system is not functioning properly. According to data from the Ministry of Health and Welfare 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 totals 5.72 billion won. The program was introduced to provide drug dispensing, sales, and professional pharmacist consultation services from 10 p.m. to 1 a.m. the following day — hours when medical access is limited. Starting with 71 locations in 2022, the program has expanded to 240 locations this year. Labor costs for the three hours of nighttime operation are set at 40,000 won per hour per pharmacist (60,000 won in population-declining areas), with the central and local governments each covering 50%. Over the five years from 2022 through this year, combined central and local government support has exceeded 18 billion won.
However, there are clear limitations to viewing public late-night pharmacies as an alternative pharmaceutical supply network for weekends and late-night hours. 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% of the total — less than 1%. Not only is the absolute number 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 Province (63). Among 89 population-declining regions where improved medical access is most urgently needed, only 24 have public late-night pharmacies, including South Jeolla (6), North Jeolla (5), Busan (4), and South Chungcheong (3). Three out of four population-declining regions remain "public blind spots" where obtaining medications during late-night hours is difficult.
Even among those in operation, only 175 keep the full hours as originally prescribed, from 10 p.m. to 1 a.m. the following day. Around 40 pharmacies — 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. Notably, 9 of the 14 public late-night pharmacies designated in South Jeolla and 5 of the 6 in Jeju Province close by 11 p.m. Critics say that despite the injection of government funds, tangible improvements in regional accessibility are hard to expect. "The budget for public late-night pharmacies has increased, but due to limitations in operating hours and regional imbalances, the public's sense of benefit remains low," Rep. Seo said. "Effective institutional improvements are needed so that telemedicine can achieve its original purpose."
