South Korea drafts telemedicine rules: 7-day cap on first-visit prescriptions
In short
South Korea's Ministry of Health and Welfare gave notice on 18 October of draft rules for telemedicine ahead of the revised Medical Service Act taking effect on 24 December. First-visit telemedicine would be allowed at clinics in the patient's own city or province, with prescriptions limited to 7 days and one 30-day exception. Platform operators, patient groups, doctors and pharmacists have all reacted, mostly over the prescription limit.
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South Korea's Ministry of Health and Welfare said on 18 October that it would give advance notice of partial amendments to the Enforcement Rule of the Medical Service Act and a rule on administrative dispositions in medical affairs. The amendments set details on eligible patients and prescribing standards ahead of the revised Medical Service Act, which takes effect on 24 December. Several outlets give the notice period as 19 October to 9 November, after which the ministry plans to finalise the text. [ 1 , 2 , 3 , 4 , 5 , 8 ]
Under the draft, standard telemedicine is for patients who had an in-person visit for the same symptoms at the institution within six months. First-visit telemedicine is allowed without such a history if the patient's registered address and the institution are in the same city or province; a registered actual residence takes precedence if entered in the telemedicine support system. Patients with rare diseases, type 1 diabetes, registered disabilities or long-term care benefits can use institutions outside their own city or province. Telemedicine is to be done in principle at clinics, with hospitals allowed in unavoidable cases. [ 1 , 2 , 3 , 5 , 6 ]
First-visit prescriptions are limited in principle to seven days. One prescription of up to 30 days is allowed if the patient's treatment and prescription history is confirmed and the doctor judges that existing treatment should continue. Narcotics, psychotropic drugs, drugs with abuse concerns and obesity drugs are in principle banned from telemedicine prescribing, with an exception for narcotic and psychotropic drugs for patients such as those with rare diseases. [ 1 , 2 , 3 , 4 , 5 ]
An institution's telemedicine cases are capped at 30% of its total per half-year. Monthly averages per practitioner over a half-year are capped at 500 for doctors and 130 for dentists and traditional-medicine doctors, with night and holiday care excluded. Platforms must report their operating details, and those with 100,000 or more cumulative subscribers must apply for certification. [ 1 , 2 , 3 , 5 ]
Reaction centred on the prescription limit. The telemedicine industry council (원격의료산업협의회) said on 19 October that the rules apply overlapping regulation and make long-term prescriptions hard, and asked for a full review. Co-chair Lee Seul (이슬) called the first-visit limit excessive. Newsis reported that patient groups said the rules amount to a practical ban. Kim Mi-young (김미영), head of the Korea Type 1 Diabetes Patients Association (한국1형당뇨병환우회), said type 1 diabetes was included as an exception to first-visit and regional limits. [ 7 , 11 , 12 , 14 ]
The Korean Medical Association and the Korean Pharmaceutical Association want the 7-day principle kept, Newsis reported. The pharmacists said the 30-day exception should not be allowed until the support system is built and then only with an in-person visit in the past six months and a 14-day limit. The medical association asked for the 30-day clause to be deleted or capped at 14 days. Park Geun-tae (박근태), head of a private practitioners' association (대한개원의협의회), said he would advise members not to write 30-day prescriptions. [ 7 , 13 , 15 ]
Chosun Ilbo reported that telemedicine was allowed temporarily from February 2020 and run as a pilot from June 2023. It said the December start would make it a formal system after six years and ten months. [ 10 ]
Why it matters
The rules set who can use telemedicine and how much medicine can be prescribed once the revised law takes effect. Outlets report objections from the telemedicine industry and patient groups, who say the limits burden people on long-term medication, while the Korean Medical Association and the Korean Pharmaceutical Association want the 7-day principle kept.
Key facts
- The Ministry of Health and Welfare said on 18 October it would give advance notice of partial amendments to the Enforcement Rule of the Medical Service Act and a rule on administrative dispositions in medical affairs; the revised Medical Service Act takes effect on 24 December. [ 1 , 2 , 3 , 4 , 5 ]
- Several outlets give the notice period as 19 October to 9 November; the ministry will finalise the amendments after collecting opinions. [ 3 , 4 , 5 , 8 ]
- First-visit telemedicine is allowed at a clinic in the same city or province as the patient's registered address, or the registered actual residence if the patient has entered one in the telemedicine support system. [ 1 , 2 , 3 , 5 ]
- Prescriptions for first-visit telemedicine are limited in principle to 7 days, with one 30-day prescription allowed if the doctor judges that existing treatment should continue and the patient's treatment and prescription history is confirmed. [ 1 , 2 , 3 , 4 , 5 ]
- Narcotics, psychotropic drugs, drugs with abuse concerns and obesity drugs are in principle banned from telemedicine prescribing, with an exception for psychotropic and narcotic drugs for patients such as those with rare diseases. [ 1 , 2 , 3 , 4 , 5 ]
- A medical institution's telemedicine cases are capped at 30% of its total per half-year; per-practitioner monthly averages over a half-year are capped at 500 for doctors and 130 for dentists and traditional-medicine doctors. [ 1 , 2 , 3 , 5 ]
- Platform operators must report their name, operating method, fees and data-safety measures, and platforms with 100,000 or more cumulative subscribers must apply for certification. [ 1 , 2 , 3 , 4 , 5 ]
Confirmed by several sources
- The ministry announced the draft rules on 18 October, ahead of the 24 December start of the revised Medical Service Act. [ 1 , 2 , 3 , 4 , 5 , 7 ]
- Patients with rare diseases, type 1 diabetes, registered disabilities or long-term care benefits may receive first-visit telemedicine at institutions outside their own city or province. [ 1 , 2 , 3 , 4 , 6 , 7 ]
- Standard telemedicine applies to patients who had an in-person visit for the same symptoms at the institution within the past 6 months. [ 1 , 2 , 3 , 4 , 5 , 7 ]
- Telemedicine is to be done in principle at clinics, with hospitals allowed in unavoidable cases such as patients with rare diseases or those needing follow-up after surgery or procedures. [ 1 , 2 , 3 , 5 ]
- Video is the principle, and voice is allowed in certain cases. [ 1 , 2 , 3 , 4 , 5 ]
- Platform operators and the telemedicine industry council object to the first-visit prescription limit, while the Korean Medical Association and the Korean Pharmaceutical Association want the 7-day principle kept. [ 10 , 11 , 12 , 15 ]
Still unclear
- Whether the one-time 30-day exception will work in practice. The telemedicine industry council said institutions cannot check whether a patient has already used the exception elsewhere and that doctors will therefore avoid 30-day prescriptions; this is the council's claim in one outlet's report.
- Whether the rules cover the scope of drug delivery. One Newsis report said the disputed scope of drug delivery was not included in this round, while other reports say the draft sets where drugs can be handed over outside pharmacies and that drugs be delivered by pharmacies in the patient's home area.
- What the final rules will say. The ministry said it would finalise the amendments after the notice period and opinions from the public and related bodies.
What local media are saying
Timeline, local time
- On 18 October, outlets report the ministry's announcement of the draft rules. [ 1 , 2 , 3 , 4 , 5 ]
- On 18 October, Dong-A Ilbo reports objections from a private practitioners' association head and the telemedicine industry council. [ 7 ]
- On 19 October, Newsis reports that the telemedicine industry council demanded a full review of the 7-day limit. [ 11 ]
- On 19 October, Newsis reports objections from both the medical community and patient and platform groups. [ 12 ]
- On 19 October, Yonhap reports that the Korean Pharmaceutical Association wants stricter prescription-day limits. [ 13 ]
- On 20 October, Newsis reports objections from type 1 diabetes patients. [ 14 ]
- On 20 October, Newsis reports pharmacists and the Korean Medical Association clashing with platforms over the 7-day limit. [ 15 ]