Although telemedicine has been legalized after six years of temporary allowance and a pilot program, opinions diverge among the medical community, the pharmaceutical sector, and platform companies over the subordinate regulations that will set concrete operating standards. The sides are at odds over whether to cap prescriptions for first-time patients at within seven days, how far to allow remote prescriptions for nonreimbursable drugs such as hair-loss and obesity treatments, and how patients should receive prescribed medications.
◇Medical and pharmaceutical sectors say "limit first-visit prescriptions to seven days"… also call for curbs on nonreimbursable drugs
Telemedicine was first introduced during the COVID-19 outbreak in 2020 and was formally institutionalized by a Medical Service Act revision in Dec. 2025. But key issues such as the scope of prescriptions for first-time patients and the implementation ratio by medical institutions have been delegated to subordinate regulations, leaving the system undefined.
The government is expected to give advance notice of legislation for the subordinate regulations on telemedicine legalization in early September. The regulations are expected to include detailed standards directly tied to actual telemedicine use, ranging from which patients can receive telemedicine, to what drugs and how much can be prescribed, to how prescribed medications can be received.
Currently, the subordinate regulations are widely expected to include a plan to limit the prescription period for first-time patients to "within seven days." The pharmaceutical sector says the Korean Pharmaceutical Association and the Ministry of Health and Welfare have already discussed the issue in a working council.
The pharmaceutical sector argues certain limits are necessary to protect patient safety and prevent medication misuse. Citing that nonreimbursable drugs account for 60.5% of remote prescriptions, they contend that first-visit prescriptions should be capped at seven days, or three days in acute cases, and that remote prescriptions for some nonreimbursable drugs, including those for hair loss and obesity, should also be restricted.
Jang Bo-hyun, policy director of the Korean Pharmaceutical Association, said at a policy forum on subordinate regulations for telemedicine held on the 13th and hosted by lawmaker Kwon Chil-seung, "The revisitation recognition period should be 'within 90 days' for the same condition. For first-visit telemedicine, prescriptions for some drugs, including hair-loss and acne treatments and high-risk medications, should be restricted, and the prescription period should be limited to 'a maximum of seven days.'"
Kim Hyeong-gap, information and communications director at the Korean Medical Association Organization, also said, "In first-visit telemedicine, some doctors may overprescribe controlled psychotropic drugs, so limits are needed," adding, "Personally, I think first-visit prescriptions should be limited to three days, but since internal views vary, the discussion is moving toward setting seven days as a consensus."
◇Opposition within the medical community as well… "Excessive curbs will inconvenience patients with chronic diseases"
However, within the medical community, there are voices—contrary to the association's official stance—saying that uniformly limiting first-visit prescriptions to seven days is excessive. They argue that one-size-fits-all restrictions that do not account for patient condition and disease characteristics could reduce access to care and continuity of treatment for patients with chronic diseases.
Kim Heon-seong, a professor of endocrinology at Seoul St. Mary's Hospital, said, "For chronic diseases, if blood pressure and blood sugar data or records via caregivers are confirmed, several months of prescriptions are possible without patients visiting the hospital," adding, "Numeric caps such as the seven-day limit for first-time patients or the 30% monthly telemedicine ratio are meaningless in clinical practice."
According to the Telemedicine Industry Council (Wonsanhyeop), most telemedicine visits were first-time consultations, accounting for about 98% of first visits by new users. Of all consultations, 45.6% involved conditions requiring ongoing medication management, such as hypertension, diabetes, rhinitis, gout, and hair loss.
Long-term prescriptions were also common. While 73% of patients with hypertension and 95.1% of patients with hair loss received prescriptions for 30 days or longer, most acute illnesses like the common cold were prescribed within seven days. Given that prescription durations already vary by disease characteristics, a blanket seven-day limit could only increase inconvenience for patients with chronic diseases.
There is concern that for patients with chronic diseases, a seven-day prescription limit could become a rule that forces unnecessary repeat visits.
A family medicine professor at a university hospital in the Seoul metropolitan area said, "For patients with hyperlipidemia or hypertension, if the numbers are stable, we usually prescribe for three to six months, so limiting prescriptions to seven days is effectively telling them not to use telemedicine," adding, "Considering office workers who cannot visit in person on weekdays and patients with gestational diabetes who must adjust insulin doses daily, a seven-day limit does not fit reality."
There is also pushback against uniformly restricting nonreimbursable drugs. They argue that the mere fact that nonreimbursable drugs such as hair-loss and obesity treatments account for a high share of telemedicine prescriptions should not lead to restricting telemedicine itself. Because nonreimbursable prescriptions are also made for the same conditions in in-person care, prescribing patterns in telemedicine and in-person care should be compared together.
Professor Kim said, "Hair-loss or diet medications should be prescribed based on medical judgment, and doctors should take responsibility," adding, "We should not devalue the merits of telemedicine—which is showing treatment effects and continuity of care comparable to in-person visits in the realm of chronic diseases—because of issues with some nonreimbursable items."
◇Major OECD countries leave it to physician discretion… "Only Korea imposes uniform curbs"
Compared with major countries overseas, critics say the uniform limits on prescription duration under discussion in Korea are excessively rigid. While major Organisation for Economic Co-operation and Development (OECD) members such as Japan, the United States, Australia, and Germany set standards to ensure the safety and quality of telemedicine, they operate in a way that broadly recognizes clinicians' judgment on specific consultations and prescriptions according to each country's health care system and clinical environment.
Choi Yong-jae, president of the Korea Association of Children's Hospitals, also emphasized, "Globally, the trend is to allow telemedicine, and greater significance should be placed on expanding patient choices in line with access to care," adding, "Telemedicine can also work to improve the quality of care."
Platform companies likewise argue that, rather than capping first-visit prescription periods or the telemedicine ratio with uniform numbers, physicians should be guaranteed clinical discretion to judge whether telemedicine is appropriate based on a patient's condition.
Lee Seul, co-chair of Wonsanhyeop, said, "Clinicians already differentiate prescription durations on their own according to disease characteristics and treatment goals. A uniform seven-day limit would replace such functioning clinical judgment with administrative standards and, at the same time, increase unnecessary follow-up burdens for patients who need long-term medication."
Patient groups also say a cautious approach is needed, as regulations that force unnecessary repeat visits could reduce patients' access to medical care.
The Welfare Ministry says it has not yet finalized specific plans for detailed standards such as first-visit prescription periods and nonreimbursable drug prescriptions. Park Jeong-hwan, head of the Medical AI Data Policy Division, said, "We are currently collecting opinions and reviewing details, so it is hard to confirm a specific timeline for advance notice of legislation," adding, "We plan to proceed with the notice process as soon as possible."
Meanwhile, in line with the institutionalization of telemedicine, the government will begin discussions on expanding who can receive medication delivery from the current groups—residents of islands and remote areas, long-term care beneficiaries, people with disabilities, and patients with infectious or rare diseases—to all telemedicine patients. To this end, revisions to related laws, including the Pharmaceutical Affairs Act and the Medical Service Act, will also be reviewed.