Ministries clash over legality of DoctorNow’s obesity drug listings

Conflicting interpretations among government ministries over telemedicine platforms displaying obesity drug brands and prices

MOHW: “Not medical advertising” vs. MFDS: “Violates the Pharmaceutical Affairs Act’s ban on direct-to-consumer advertising of prescription drugs”

Interministerial confusion ahead of transition to permanent program…Criticism rises on how regulators are “turning a blind eye to workaround marketing and drug misuse”

Conflicting positions from the Ministry of Health and Welfare and the Ministry of Food and Drug Safety over the display of brand names, dosages, prices and prescribing clinics for prescription obesity drugs such as Wegovy and Mounjaro on apps operated by DoctorNow and other telemedicine platforms are creating serious regulatory confusion.

The Ministry of Health and Welfare concluded that the practice of displaying on telemedicine platforms the prices or brand names of injectable obesity treatments available at hospitals and clinics following an in-person consultation—on the basis that such treatments, while restricted from telemedicine prescribing, may be prescribed in person—is unlikely to constitute medical advertising prohibited under the Medical Service Act.

The Ministry of Food and Drug Safety, however, expressed a different view, stating that identifying the names or effects of prescription drugs through telemedicine apps or other online media could violate the Pharmaceutical Affairs Act, which prohibits direct-to-consumer advertising of prescription drugs.

These were the positions provided by the ministries on the 26th regarding the display of injectable obesity drug brands, dosages, out-of-pocket prices and prescribing institutions on telemedicine apps.

Telemedicine platform operators currently provide information through their apps that allows patients to select the weight-loss injection they wish to have prescribed.

The apps display partially redacted names from which users can infer popular injectable and oral drug brands, such as MouOOO, WegOO, SaxOO and ConOOO.

After selecting or tapping a partially redacted brand name (by touch or click), users are presented with the available dosages and can even choose the quantity they wish to receive.

The patient can then visit the relevant medical institution for an in-person consultation and receive the selected prescription obesity drug in the chosen dosage and quantity.

Doctors, pharmacists and other healthcare professionals have criticized platforms’ display and promotion of obesity drug brands, dosages, out-of-pocket prices and prescribing institutions, arguing that the practice may violate existing laws.

The two ministries, however, reached different conclusions. While MOHW judged it could not definitively characterize the practice as illegal advertising prohibited under the Medical Service Act, the MFDS concluded that it could constitute advertising of prescription drugs prohibited under the Pharmaceutical Affairs Act.

MOHW, “Difficult to regard as medical advertising prohibited under the Medical Service Act”

Based on the Medical Service Act, the MOHW determined that listing obesity drug brand names on a telemedicine platform app was unlikely to constitute illegal medical advertising.

Although obesity drugs cannot generally be prescribed through telemedicine, they may be prescribed following an in-person consultation. The ministry therefore maintains that displaying information about clinics where such prescriptions are available, along with drug names and prices, is unlikely to constitute medical advertising prohibited under the Medical Service Act.

However, the MOHW said it would consider introducing provisions prohibiting the display of prescribing institutions, brand names, and prices for obesity drugs in the course of discussing subordinate legislation, as the amended Medical Service Act establishing telemedicine as a permanent program has created a legal basis for the supervision and regulation of platform operators.

MFDS, “Violates the Pharmaceutical Affairs Act’s ban on prescription drug advertising”

Unlike the MOHW, the MFDS pointed out that posting prescription drug brand names or dosages on telemedicine apps has potential legal violations.

The current Pharmaceutical Affairs Act strictly prohibits direct-to-consumer advertising of prescription drugs, which require a physician’s prescription.

According to the ministry, displaying the name or effects of a prescription drug through an online medium such as a telemedicine platform may be considered an act of broadly communicating or presenting information about a particular medicine to telemedicine users and consumers.

The ministry therefore concluded that the practice could violate the Pharmaceutical Affairs Act’s prohibition on direct-to-consumer advertising of prescription drugs.

Interministerial discord… “worsens regulatory blind spots for platforms”

The same display and advertising practice on telemedicine platforms has thus been deemed clearly unlawful by one ministry and unobjectionable under existing law by another, creating confusion for both the industry and consumers.

Critics argue that the MOHW, which oversees national health policy, has given a de facto free pass by passively interpreting the situation—where specific prescription drug names and prices are openly exposed to the public—solely based on the formal criteria of the Medical Service Act.

They also criticize the ministry’s passive stance, saying only that it will consider the issue when “drafting subordinate legislation,” even though telemedicine prescribing of obesity drugs has been restricted over concerns about misuse and platforms are circumventing the restriction by serving as gateways connecting patients with clinics and drug prices.

With telemedicine scheduled to transition to a permanent program on Dec. 24, continued controversy over the indiscriminate advertising, promotion, display and commercialization of prescription drug information through platforms has prompted calls for the ministries to swiftly reconcile their positions and establish clear regulatory standards.

Medical and pharmacy groups said, “While the MFDS has clearly concluded that the practice violates the Pharmaceutical Affairs Act, the MOHW is leaving a regulatory vacuum to persist by creating the impression that it is lawful under the Medical Service Act. Poor communication between ministries and their lukewarm administrative response are encouraging workaround marketing by platforms and the misuse of medicines.”