🚨 Medicine Separation Exception Areas

Today Korean Social News for Beginners | 2025.11.04

0️⃣ Controversy Over Dispensing Medicine Without Prescriptions and Home Delivery

📌 "Medicine Delivered Without Prescription"... Exception Area Pharmacies Misusing the System

💬 Some pharmacies in medicine separation exception areas are increasingly dispensing prescription drugs without doctor's prescriptions and even delivering them by courier. This system was created to help people in rural areas where hospitals are scarce, but some pharmacies are abusing it for profit. Over the past 5 years, 32 violations of pharmacy law have been found in these exception areas. The violations included dispensing more than 3 days' worth of prescription drugs, selling without prescriptions, and non-face-to-face delivery. Over 33% of these pharmacies make no health insurance claims at all. Experts warn that poor oversight is encouraging drug misuse and damaging trust in the system.

💡 Summary

• Exception areas are places where pharmacies can dispense medicine without prescriptions due to lack of hospitals.
• Some pharmacies are abusing the system by illegally dispensing prescription drugs and delivering them by courier.
• 32 violations have been found in 5 years, and over 33% of pharmacies make no health insurance claims.

1️⃣ Definition

Medicine separation exception areas are rural towns, villages, and island areas where pharmacies are allowed to dispense certain medicines without prescriptions to improve healthcare access when hospitals and clinics are scarce. Korea's medicine separation system started in 2000, requiring doctors to prescribe and pharmacists to dispense separately. However, some areas were designated as exceptions to help people in places with few medical facilities.

The original purpose was to help people in medically underserved areas get essential medicines for emergencies or chronic disease management. However, recently some pharmacies have been selling prescription drugs carelessly to outsiders and delivering them by courier, damaging the system's purpose.

💡 Why is this important?

• It is the minimum safety net to protect the lives and health of people in medically vulnerable areas.
• It is a key system for drug safety management to prevent drug misuse and side effects.
• System abuse threatens public health and reduces trust in the medical system.
• The government needs to strengthen its management and supervision urgently.

2️⃣ Current Situation and Problems of Exception Areas

📕 Background and Standards for Designation

• The medicine separation system was fully implemented. Key details are:

  • In July 2000, medicine separation was fully implemented with doctors prescribing and pharmacists dispensing.
  • The goal was to reduce drug misuse and increase transparency in medicine distribution.
  • There was initial controversy over public inconvenience and pharmacy closures, but long-term it became key to safety management.
  • However, people in areas with few hospitals had more difficulty getting medicine.

• Exception areas were designated. Key standards include:

  • The Ministry of Health designated rural towns, villages, and islands with low healthcare access as exception areas.
  • They evaluate the number of medical facilities and pharmacies, transportation, and population by city, county, and district.
  • Pharmacies in these areas can only dispense within the minimum range for local residents' convenience.
  • Prescription drugs can be dispensed up to 3 days' supply only, excluding narcotics.

📕 Cases of System Abuse and Increasing Violations

• Dispensing prescription drugs without prescriptions is increasing. Main problems include:

  • 32 violations of pharmacy law have been found in exception area pharmacies over the past 5 years.
  • Common cases include dispensing more than 3 days of prescription drugs or selling without prescriptions.
  • Some pharmacies operate commercially, mass-dispensing to outsiders.
  • Promotions on social media and online communities claim "you can buy medicine without a prescription."

• Courier delivery and non-face-to-face sales are spreading. Key findings include:

  • More pharmacies are taking orders by phone or messenger and sending prescription drugs by courier.
  • The system was meant for local residents, but sales to outsiders are happening carelessly.
  • Over 33% of pharmacies make no health insurance claims, showing very low transparency.
  • Not checking patients' medication history or health status increases the risk of drug side effects.

📕 Gaps in Management and Supervision

• Government and local inspections are poor. Main problems include:

  • Regular inspections of exception area pharmacies are done superficially.
  • Lack of staff and budget means field enforcement is inadequate.
  • Even when caught, only minor administrative actions are taken, so violations keep happening.
  • The system to cross-check health insurance claims and actual sales is insufficient.

• System improvements are delayed. Key criticisms include:

  • Even though healthcare has improved, exception areas are not being re-evaluated properly.
  • Some areas now have better transportation and more hospitals but remain exception areas.
  • There is no computer system to monitor pharmacy sales items and quantities in real-time.
  • Strict standards and strong penalties are needed to match the system's purpose.

💡 Major Problems in Exception Areas

1. System purpose distorted: Business targeting outsiders instead of local residents
2. Drug safety threatened: Increased risk of side effects from dispensing prescription drugs without prescriptions
3. Management blind spot: 33% of pharmacies make no insurance claims, seriously low transparency
4. Weak law enforcement: Minor penalties even when violations are found, limited prevention of repeat violations
5. Delayed system improvements: Poor re-evaluation of exception areas despite healthcare changes

3️⃣ Response Measures and Future Tasks

✅ Strengthening Management and Supervision

• Regular inspections and enforcement must be strengthened. Key measures include:

  • Significantly increase surprise inspections of exception area pharmacies.
  • Build a cooperation system between local governments and the Health Insurance Review Agency for comprehensive management.
  • Introduce a system to cross-verify health insurance claims and actual sales records.
  • Investigate immediately when suspicious cases are found and take strict action against violations.

• Penalties must be increased. Key directions include:

  • Impose strong administrative penalties like business suspension or license revocation for pharmacy law violations.
  • Actively consider criminal punishment for habitual violations or malicious system abuse.
  • Designate mass-dispensing to outsiders or courier sales as subjects for heavier punishment.
  • Publicly disclose violation cases to raise awareness in other pharmacies and prevent recurrence.

✅ System Improvements and Transparency

• Exception area designation standards must be reorganized. Key tasks include:

  • Remove exception area designation for areas where transportation and healthcare have improved.
  • Regularly re-evaluate every 3-5 years to reflect actual healthcare accessibility.
  • Create clear indicators combining population, number of hospitals, and transportation conditions.
  • Survey actual demand and usage patterns of local residents to refine the system.

• A computer system must be built. Key directions include:

  • Introduce a system to manage exception area pharmacy dispensing records in real-time.
  • Require mandatory input of patient information and dispensing records when selling prescription drugs.
  • Impose separate reporting requirements for dispensing without health insurance claims.
  • Link data with the National Health Insurance Service to automatically detect abnormal transactions.

✅ Raising Public Awareness and Encouraging Reports

• The public must be informed accurately about the system. Key methods include:

  • Promote the purpose and limitations of the exception area system.
  • Educate about the dangers of taking prescription drugs without prescriptions.
  • Inform that drug misuse can cause serious side effects like liver and kidney damage and drug dependence.
  • Guide people to report suspicious pharmacies to health centers or the insurance corporation.

• Inconvenience to local residents must be minimized. Key measures include:

  • Ensure system improvements don't harm residents who really need it.
  • Provide alternatives like expanding telemedicine or operating mobile clinics.
  • Strengthen the supply system for essential medicines for emergencies or chronic disease management.
  • Increase safe and convenient medicine accessibility through cooperation between local health centers and pharmacies.

4️⃣ Related Terms Explained

🔎 Medicine Separation

• Medicine separation is a system that divides the roles of doctors and pharmacists.
  • Medicine separation means doctors examine patients and issue prescriptions, while pharmacists dispense medicine according to prescriptions and provide medication guidance. It was introduced to prevent drug misuse and increase transparency in medicine distribution.
  • The main features are: First, doctors issue prescriptions after examining patients. Second, patients visit pharmacies with prescriptions. Third, pharmacists check prescriptions, dispense medicine, and provide guidance. Fourth, pharmacies within medical facilities are closed and outpatients must use external pharmacies.
  • Korea fully implemented medicine separation in July 2000. Initially there was great controversy over public inconvenience, increased medical costs, and pharmacy closures, but long-term it became a key drug safety management system. However, exception areas were designated for areas with few hospitals.

🔎 Prescription Drugs

• Prescription drugs are medicines that need a doctor's prescription.
  • Prescription drugs are medicines that can only be bought at pharmacies with a prescription from a doctor or dentist. They are drugs with strong effects or high risk of side effects that must be taken under professional guidance. Examples include antibiotics, blood pressure medicine, diabetes medicine, anticancer drugs, and psychotropic drugs.
  • The opposite of prescription drugs is over-the-counter (OTC) drugs. OTC drugs can be bought freely at pharmacies without a prescription, are relatively safe, and consumers can decide to take them themselves. Cold medicine, digestive medicine, and painkillers belong here.
  • Taking prescription drugs without a prescription is seriously dangerous. First, you may misdiagnose the disease and miss treatment timing. Second, side effects may occur from interactions with other drugs. Third, overdose or misuse can harm health like liver or kidney damage. Fourth, long-term problems like antibiotic resistance can develop.

🔎 Pharmacy Law

• Pharmacy law regulates medicines and pharmacists.
  • Pharmacy law is legislation that regulates the duties of pharmacists and herbal medicine pharmacists, and the manufacturing, sales, and management of medicines, aimed at improving public health. It is the legal basis for ensuring medicine quality and safety, guaranteeing pharmacist expertise, and establishing proper medicine distribution order.
  • Main contents include: First, it regulates pharmacist and herbal medicine pharmacist licenses and scope of work. Second, it sets approval standards for medicine manufacturing, import, and sales. Third, it specifies matters about pharmacy establishment and operation. Fourth, it sets principles for prescription dispensing and medicine sales. Fifth, it regulates administrative penalties and punishments for violations.
  • Illegal acts by exception area pharmacies violate pharmacy law. Dispensing prescription drugs without prescriptions, dispensing more than 3 days' supply, or selling by courier all violate pharmacy law. Violations can result in administrative penalties like business suspension, fines, and license revocation, as well as criminal punishment.

🔎 Drug Misuse and Abuse

• Drug misuse and abuse means using medicine incorrectly.
  • Drug misuse and abuse means using medicine differently from its medical purpose, not following dosage and usage, or taking it without prescription and harming health. Misuse is using it wrongly by mistake or ignorance, while abuse is intentionally using it excessively.
  • Types include: First, overdosing causes side effects like liver and kidney damage. Second, taking multiple drugs together increases danger from drug interactions. Third, arbitrarily taking prescription drugs without doctor's prescription. Fourth, using antibiotics carelessly creates resistant bacteria. Fifth, becoming dependent on painkillers or sleeping pills and getting addicted.
  • Dispensing prescription drugs without prescriptions in exception areas encourages drug misuse. Selling medicine without checking the patient's medical history and current medications can cause serious side effects from duplicate medication or taking contraindicated drugs. For public health, medicine must be taken according to doctor's diagnosis and prescription.

5️⃣ Frequently Asked Questions (FAQ)

Q: What medicines can be bought without prescription in exception areas?

A: Over-the-counter drugs can be bought freely, but prescription drugs are limited to 3 days' supply.

• Even in exception area pharmacies, over-the-counter drugs (cold medicine, digestive medicine, painkillers, etc.) can be bought freely without a prescription. This is the same as regular pharmacies outside exception areas. However, for prescription drugs, while a prescription is needed in principle, in exception areas up to 3 days' supply can be dispensed in limited cases for emergencies or chronic disease management. First, chronic disease medicines like blood pressure or diabetes medicine are allowed up to 3 days. Second, restrictions are stricter for high-risk drugs like antibiotics or psychotropic drugs. Third, narcotics can never be dispensed without a prescription.
• However, the problem is that some pharmacies actually break this rule and mass-dispense prescription drugs or sell them by courier. While it may be convenient for patients, there is high risk of drug side effects or addiction, so it is safe to get a doctor's diagnosis and take medicine according to prescription.

Q: Are there similar problems in areas that are not exception areas?

A: There are some illegal acts in some pharmacies, but not as serious as exception areas.

• Even in regular pharmacies, illegal acts of selling prescription drugs without prescriptions are not completely absent. Some pharmacies give medicine without prescriptions to regular customers as a convenience, or illegally sell online. However, regular areas strictly enforce medicine separation, and are managed through the health insurance claims system, so the risk of detection is high. First, most pharmacies follow medicine separation principles. Second, penalties like business suspension or license revocation are strict for violations. Third, transparency is high as health insurance claims are routine.
• On the other hand, exception areas are allowed exceptions by the system, so the boundary between illegal and legal is unclear, and management and supervision are poor. Cash transactions often happen without health insurance claims, making it hard to reveal violations. Therefore, strengthening management of exception areas is especially important.

Q: What are the dangers of buying medicine without a prescription?

A: There are various dangers including side effects, drug interactions, and disease worsening.

• Taking prescription drugs without a prescription exposes you to many serious dangers. First, disease may worsen from wrong self-diagnosis. Choosing medicine based only on symptoms may miss the accurate cause and delay treatment timing. Second, drug side effects may occur. Prescription drugs have strong effects and equally strong side effects. People with weak liver or kidney function, elderly, and pregnant women are especially at risk. Third, there are problems of interactions with other drugs. Newly bought medicine may interact with medicine already being taken, reducing effectiveness or increasing toxicity. Fourth, long-term problems like antibiotic resistance develop. Taking antibiotics carelessly can create resistant bacteria that won't work when really needed.
• There is also risk of drug dependence or addiction. Continuously taking sleeping pills, painkillers, or tranquilizers can make it difficult to live without them. Therefore, it is safe to get a doctor's diagnosis and take medicine according to prescription. Pharmacist guidance is also important, so you should get a prescription, go to a pharmacy, get accurate explanation, and take medicine.

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