Costly at home, confiscated at customs: Korea's weight-loss drug rules spark backlash

Government restrictions on bringing weight-loss drugs into Korea — even when they have been legally prescribed by medical institutions overseas — are drawing criticism for blocking genuine medications rather than just counterfeit or illegally distributed products.

Even a genuine Mounjaro pen purchased at a licensed pharmacy with a prescription issued in the patient's name by a medical institution overseas cannot be brought into Korea, according to the Ministry of Food and Drug Safety and other authorities.

This means foreign tourists and international students may also face customs problems when entering Korea with medication prescribed for their treatment. Similar issues can arise when patients bring medication prescribed in Korea during overseas trips and attempt to bring it back into the country upon return.

The Drug Ministry reaffirmed the restrictions in September, stating that it had stepped up customs inspections amid a sharp increase in Mounjaro and Wegovy being brought into Korea. It explained that the weight-loss drugs are classified as potentially harmful medications on a list it has submitted to the Korea Customs Service and can clear customs only if certain import requirements are met, including obtaining an exemption recommendation certificate for import requirement verification.

Complaints about the restrictions have grown amid rising interest in "Sushi-jaro," a term combining sushi and Mounjaro, which refers to the drug purchased in Japan.

"I even brought the prescription I received in Japan, but customs confiscated the medication," one user wrote on an online community for people with obesity.

Another wrote that customs was "checking everything with X-rays, so even putting it in my pocket didn't work."

Others criticized the government for blocking genuine medication legally purchased overseas without taking steps to ease the financial burden on patients, despite prices in Korea being more than three times higher than in Japan.

A four-week supply of Mounjaro at the starting dose of 2.5 milligrams costs approximately 280,000 to 350,000 won ($210 to $260) in Korea, compared with around 80,000 to 120,000 won at some medical institutions in Japan.

Japan covers Mounjaro under its national health insurance system as a treatment for type 2 diabetes, allowing the government to regulate its price. It also cut the drug's price by 25 percent in August following a surge in sales.

In Korea, Mounjaro is not covered by national health insurance even for diabetes treatment, leaving it outside the government's drug price negotiation system.

Weight-loss medications are generally used over extended periods, often for a year or longer, making consistent treatment and monitoring essential.

A major clinical trial of Mounjaro ran for 72 weeks and found that patients often regained weight after stopping treatment. But the cost makes long-term treatment difficult for patients with limited financial resources, leading some in Korea to seek cheaper prescriptions in Japan.

The Drug Ministry maintains that direct overseas purchases of pharmaceuticals — which include foreign sellers directly shipping and selling medications to Korean consumers — violate the Pharmaceutical Affairs Act.

The ministry compiles a list of medications that have been subject to enforcement against illegal online sales and notifies the Korea Customs Service. Weight-loss drugs, including Mounjaro, were added to the list in October 2024 to block direct overseas purchases.

The Korea Customs Service applies the same list to medications carried by travelers entering the country.

"Medications included on the list cannot be brought into the country by travelers, even if they are intended for personal use," the Drug Ministry said.

The ministry cited difficulties in verifying the safety and quality of medications purchased directly from overseas sellers. It also noted that consumers may have limited legal protection for overseas-purchased drugs, including access to recalls or compensation, if problems arise.

However, others argue that illegal online sales of pharmaceuticals should be treated separately from travelers personally carrying genuine medications legally prescribed overseas.

"Some people are taking these injections because they genuinely have a medical condition," Reform Party Rep. Lee Jun-seok said during a parliamentary audit of the Korea Customs Service on Thursday. "If they have certification or a prescription, customs authorities should treat them differently. They should be allowed to bring them in for medical purposes."

Korea Customs Service Commissioner Lee Jong-wook explained that customs clearance was being suspended because the Drug Ministry notified the agency that the medications were harmful.

"We will actively consult with the Drug Ministry," Commissioner Lee said in response to questions about allowing medications to be brought into the country for genuine treatment.

Park Yong-jin, vice chair of the Regulatory Rationalization Committee, also called for a review of the restrictions.

"We need to examine whether it is appropriate to block even medications that people bring in with prescriptions," Park told the JoongAng Ilbo in a phone interview.

Park also criticized a separate Drug Ministry proposal to designate weight-loss drugs as medications with a risk of misuse or abuse.

"It would do little to prevent misuse or abuse and would only create fear among patients using the medications," Park said. "If we recognize obesity as a disease and want to manage it safely, we need to bring treatment into the regulated health care system."

Medical experts also called for measures to make treatment more accessible.

"The Japanese government actively negotiated with pharmaceutical companies to lower drug prices," said Oh Sang-woo, a professor of family medicine at Dongguk University Ilsan Hospital.

"We should also recognize severe obesity as a disease within the national health insurance system and reduce treatment costs for those who truly need it, including patients who also have diabetes," Oh added.

BY RHEE ESTHER [[email protected]]