Medical and Pharmacy Groups Clash with Industry Over 'Telemedicine' Rules

Korean Medical Association and Korean Pharmaceutical Association: "Safeguards weakened... proposal must be reconsidered in full"
RMIA criticizes "duplicative regulations that undermine patient access to care"

After the government announced proposed amendments to subordinate statutes to institutionalize telemedicine, medical and pharmacy organizations and industry groups expressed differing views. Medical and pharmacy organizations called for the proposal to be reconsidered, saying it lacks adequate safeguards for patient safety and to prevent the misuse and overuse of medicines. In contrast, the remote medical platform industry criticized the proposed limits on prescription periods, saying they could restrict patients' access to care and increase unnecessary consultations and out-of-pocket costs.

In a statement on October 19, the Korean Medical Association said, "The four principles of telemedicine—complementing in-person care, focusing on follow-up patients, centering on clinics, and prohibiting facilities dedicated to telemedicine—are being undermined in the subordinate statutes." The Korean Pharmaceutical Association also expressed concern, saying, "There are insufficient safeguards for patient safety, including limits on prescription periods, the establishment of a public system, and the management of medicine delivery."

The biggest point of contention is the prescription period for first-time patients. Under the Ministry of Health and Welfare's proposed amendments, prescriptions issued through telemedicine to first-time patients would generally be limited to seven days. However, a prescription of up to 30 days would be permitted once if the patient's previous consultation and prescription history can be confirmed and the physician determines that continuing the existing treatment is necessary.

The Korean Medical Association said this exception could allow long-term prescriptions for first-time patients and undermine the seven-day limit. It argued that the provision allowing 30-day prescriptions for first-time patients should be removed and that any necessary exceptions should be limited to 14 days.

The Korean Pharmaceutical Association stressed that prescription-period limits should be tightened further. It said the seven-day limit should remain in place until a telemedicine support system is established that can check prescription records from other medical institutions in real time and prevent duplicate prescriptions. Even after the system is established, it called for strict limits on which medical histories qualify for exceptions, such as records of in-person consultations within the past six months, and for prescriptions issued through follow-up telemedicine consultations to be limited to a maximum of 60 days per prescription.

In contrast, the Remote Medical Industry Association (RMIA) countered that "allowing the 30-day prescription exception only once is a regulation that would be difficult to implement in clinical practice." It said that, without a system for medical institutions to check whether patients have visited other hospitals or whether an exception has already been applied, holding healthcare professionals responsible for violations could discourage doctors from issuing exception prescriptions altogether.

A previous RMIA survey found that 58.0% of telemedicine users with chronic or monitored conditions said they received prescriptions for more than 30 days. The RMIA said, "If patients who use other medical institutions are subject to the limit on prescriptions for first-time consultations, they will have to consult a doctor repeatedly to obtain the medicines they need." It added, "The proposed amendments should be reconsidered so that doctors can determine prescription periods based on patients' medical histories and their own medical judgment."

Regulations intended to prevent facilities dedicated to telemedicine have also become a point of contention. The proposed amendments would limit telemedicine to 30% of a medical institution's consultations and cap the monthly average at 500 consultations per physician, while excluding consultations on weekdays after 8 p.m., Saturdays after 6 p.m., and holidays from the calculation. The Korean Medical Association and the Korean Pharmaceutical Association said, "Excluding evening and holiday consultations from these limits could lead to medical institutions that effectively provide only telemedicine." They added, "Supervision and penalties should be strengthened to prevent private platforms from favoring specific medical institutions or encouraging the misuse and overuse of medicines."

The Korean Pharmaceutical Association also raised concerns about the system for managing medicine delivery. It said the patient groups and geographic areas eligible to receive medicines outside pharmacies should be strictly limited, and that a registration system for delivery providers and penalties for violators should be established. It also called for privacy standards to prevent information about patients' medicines from being exposed during delivery, as well as the swift establishment of an electronic prescription transfer system and a telemedicine support system.

The Korean Medical Association said, "Telemedicine can protect public health only if it is permitted as a means of complementing in-person care," adding, "If the proposed amendments are finalized, we will carefully consider with our members whether to participate in telemedicine." The Korean Pharmaceutical Association likewise called for "stronger regulations to ensure medicine safety and protect patients."

In contrast, the RMIA said, "We agree with the principle that telemedicine should operate as a complementary means of providing in-person care." However, it countered, "Regulations intended to protect patient safety should not instead restrict access to care and increase medical costs."

This content was produced with the assistance of AI translation services.