[비즈한국] There is fierce backlash from the pharmacy sector against the non-face-to-face medical service platform 'Dr. Now.' Pharmacists claim that Dr. Now violated the Fair Trade Act and the Pharmaceutical Affairs Act by requiring pharmacists to purchase drugs through its own wholesale subsidiary, 'Bijin Pharm,' and providing preferential treatment to pharmacies that complied. Recently, they also criticized Dr. Now’s TV advertising slogan, "From non-face-to-face diagnosis to prescription drug pickup," labeling it as exaggerated and illegal advertising. As the conflict between the platform and the pharmacy sector deepens, some point out that patients are suffering the consequences due to the authorities' passive approach toward the "institutionalization of non-face-to-face treatment."
Pharmacy Sector: "Concerns Over Drug Misuse and Dependency on Platforms"
Recently, allegations of Fair Trade Act violations emerged regarding 'Bijin Pharm,' a drug wholesaler established by Dr. Now. It is alleged that Dr. Now granted the status of "affiliated pharmacy" to those that purchased a 1-million-won package of drugs through Bijin Pharm, and provided preferential treatment by displaying a "dispensing confirmed" mark on these pharmacies, exposing them at the top of the app interface. Rep. Kim Yoon of the Democratic Party of Korea recently released a message sent by a Dr. Now manager to a pharmacist, stating, "Please substitute with Bijin Pharm products as much as possible for Dr. Now dispensing cases." The pharmacy sector reacted by calling this a "violation of the Fair Trade Act and the Pharmaceutical Affairs Act."
During the parliamentary audit on the 23rd of last month, Dr. Now CEO Jeong Jin-woong appeared as a witness and explained, "About 35% of non-face-to-face patients at night or on holidays are unable to receive their medication. After various attempts, we concluded that supplying drugs directly to pharmacies and linking inventory is a way to provide information about nearby drug stock to patients." He added, "However, as I have realized through this audit that the intent and purpose of our service could be misunderstood, I will take measures to improve it and strive to provide a more public-interest-oriented service."
The pharmacy sector has been demanding the "complete withdrawal of non-face-to-face treatment" since the inception of such platforms. While the issue with Dr. Now has recently surfaced, they have long expressed a negative stance toward non-face-to-face care. As the COVID-19 crisis level was downgraded from "severe" to "alert," the government implemented a limited pilot project for non-face-to-face treatment and has "fully permitted" it since February this year. At each stage, platform operators released patient satisfaction surveys and demanded deregulation such as "permitting drug delivery," while the pharmacy sector issued statements and held press conferences to criticize the government for "unilaterally implementing the project."
Pharmacists point to the misuse and abuse of medication as a major problem, noting that it is relatively easy to get prescriptions for narcotics or psychotropic drugs through non-face-to-face treatment. They argue that despite being prohibited in principle, such prescriptions are being issued due to weak regulations. In fact, according to 'Narcotic Benefit Prescription Status' data received by Rep. Park Hee-seung of the Democratic Party from the Ministry of Health and Welfare, 8 narcotic ingredients and 36 psychotropic ingredients were prescribed between June last year and April this year. By case count, 20 narcotic prescriptions and 2,712 psychotropic prescriptions were issued, including 'Fentanyl.' The figures are expected to rise further if non-benefit narcotics are included.
Dependency on platforms is another source of concern. The Gyeonggi Pharmaceutical Association recently issued a statement claiming, "The government is inciting the public by prioritizing the industrialization of healthcare and the digitization of medical services, claiming that the principles of face-to-face treatment and dispensing are outdated. Permitting non-face-to-face treatment and drug delivery ultimately means that the Republic of Korea's healthcare system will become completely dependent on a few private platforms. We have already witnessed the damage to numerous small-scale vendors subservient to giant delivery apps, and the resulting side effects such as local economic stagnation and distortion of distribution channels."
Patients Using Platforms Wait an Average of 3 Hours to Receive Medication
The problem is that while the government remains inactive in "institutionalizing non-face-to-face treatment," patient suffering is accumulating. Instances of patients wandering around in search of a pharmacy that can fill their prescriptions—a phenomenon called "pharmacy hopping"—or having to receive face-to-face treatment again at hospitals near pharmacies have persisted since the early days of the pilot project. Online community boards are filled with testimonials from parents saying, "The pharmacist refused to give me the medication, saying they don't accept non-face-to-face prescriptions." According to Ministry of Health and Welfare data released during the recent parliamentary audit, the average travel distance and time for platform users to receive medication was 4.55 km and 3.3 hours on weekdays, and 4.77 km and 10.05 hours on holidays and nights.
Doctors and pharmacists also face difficulties. According to a '1-year perception survey of the non-face-to-face treatment pilot project' commissioned by the Telemedicine Industry Association to Korea Research last June, doctors and pharmacists who evaluated the pilot project negatively cited reasons such as "confusion due to frequent policy changes, including patient eligibility criteria (67.6% of doctors, 49.1% of pharmacists)" and "restrictions on delivery of prescription drugs (61.8% of doctors, 36.8% of pharmacists)." Regarding the medication pickup process, 41.1% of pharmacists pointed to factors like "having to wait indefinitely because it's unclear when the patient will visit (76.1%)" and "having to respond individually to calls checking for drug stock (58.7%)."
The government temporarily "fully permitted" non-face-to-face treatment following the mass resignation of resident doctors. However, the scope for home delivery of medication remains restricted to those living in islands or remote areas, the mobility-impaired (those 65 or older with long-term care ratings or the disabled), patients confirmed with infectious diseases, and patients with rare diseases. Following the dispatch of public health doctors, non-face-to-face treatment was also permitted at public health centers and health substations, which were previously excluded. While the scope of non-face-to-face treatment has expanded over the past two years, the government has only repeatedly revised its "pilot project guidelines" without any discussion of formal institutionalization. Among these, the guidelines for "intermediary platforms" have not been revised since last year, unlike those for medical institutions and pharmacies.
Prior to the general election in April, the People Power Party and the Democratic Party included pledges related to non-face-to-face treatment in their platforms. While the focus was largely on "institutionalization" to clarify disease scope and criteria, the Democratic Party focused more on regulation, including plans for: △prohibiting medical institutions dedicated exclusively to non-face-to-face treatment, △strengthening reasonable regulation and management of platform operators, and △establishing and utilizing a public electronic prescription delivery system. Since Minister of Health and Welfare Cho Kyoo-hong mentioned during the recent parliamentary audit that the legalization of non-face-to-face treatment is necessary, medical circles expect discussions to focus heavily on the "platform operators" currently at the center of the conflict.