GLP-1 misuse/abuse drug designation delayed into 2H

MFDS completes internal review, awaits Regulatory Reform Committee review…” aims to revise rules within September”

Measure delayed despite April advisory panel review and June administrative notice…industry warns of return to psychotropic drugs and growth of counterfeit black market

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The designation of glucagon-like peptide-1 (GLP-1) obesity treatments as drugs of concern for misuse or abuse, which was expected to be completed by the end of August, has been pushed into September and is now facing regulatory review.

The Ministry of Food and Drug Safety (MFDS) is currently undergoing a regulatory review by the Regulatory Reform Committee under the Office for Government Policy Coordination. It plans to complete the revision of the relevant notification within this month.

However, pharmaceutical companies and medical professionals are strongly opposing the move, warning that higher prescribing hurdles and greater psychological barriers could create a “balloon effect,” driving patients back to more addictive psychotropic obesity drugs or toward illegally distributed and counterfeit medicines online.

From CPAC review to June advance notice…internal review completed, now to be submitted to the Regulatory Reform Committee

The process of designating GLP-1 obesity drugs as drugs of concern for misuse or abuse gained momentum in April this year. At the time, the MFDS Central Pharmaceutical Affairs Council endorsed the designation, citing soaring demand for major obesity drugs including Wegovy (semaglutide), Mounjaro (tirzepatide) and Saxenda (liraglutide), as well as a concentration of supplies in areas exempt from Korea's prescription-dispensing separation system.

The MFDS subsequently issued an advance administrative notice from June 5 to 26 on a proposed partial revision to the “Regulations on the Designation of Drugs of Concern for Misuse or Abuse.” The proposal calls for newly designating products containing three active ingredients, liraglutide, semaglutide and tirzepatide, for obesity treatment as drugs of concern for misuse or abuse.

Once designated, the products would be required to carry the wording “drug of concern for misuse or abuse” on their containers and packaging. Pharmacies in areas exempt from the prescription-dispensing separation system would also be prohibited from dispensing or selling the products without a physician's prescription.

The MFDS regulatory impact assessment originally set Aug. 31, 2026, as the start of the regulatory review period, leading to widespread expectations that the notification would be revised and take effect immediately by the end of August. However, the target has since been pushed back to September as the government's regulatory review process has taken longer than expected.

The proposal is currently under review by the Regulatory Reform Committee under the Office for Government Policy Coordination. Responding recently to questions from pharmaceutical trade media, the MFDS said, “We have completed the regulatory review by our internal regulatory review committee, and the proposal is currently under review by the Regulatory Reform Committee under the Office for Government Policy Coordination. We are proceeding intending to revise the notification in September, depending on the regulatory review schedule.”

However, the agency declined to disclose the number of comments submitted by pharmaceutical companies, importers and medical groups during the advance-notice period or the specific issues raised. “We are reviewing the matter while taking the submitted opinions into comprehensive consideration, and it is difficult to provide detailed responses at this stage.”

The MFDS intends to maintain the scope of products covered under the original advance notice. Regarding Mounjaro in particular, which is approved for both diabetes and obesity, the agency clarified that “products containing the three ingredients for obesity treatment will be required to display the wording ‘drug of concern for misuse or abuse’ on their containers and packaging.”

The MFDS also emphasized the need for tighter distribution controls in prescription-dispensing exemption areas: “In joint inspections with local governments during the first quarter of this year covering 632 sites, we identified six violations, including four pharmacies in exemption areas that sold drugs without prescriptions and two medical institutions where medicines were used by physicians themselves.”

Industry warns “designation could stigmatize drugs and restrict treatment opportunities”

On the other hand, the pharmaceutical industry and related academic groups are strongly opposing the regulation, arguing that it could distort the obesity treatment environment and lead to unintended consequences.

One of the industry's biggest concerns is a potential “balloon effect” toward conventional psychotropic obesity drugs. If GLP-1 therapies are stigmatized by a regulatory label associated with “misuse and abuse” and access to prescriptions becomes more restricted, patients could turn back to controlled appetite suppressants such as phentermine and phendimetrazine, which are relatively inexpensive and easier to obtain. They say this would create a contradiction in which excessive restrictions are imposed on newer drugs with comparatively well-established safety profiles even though psychotropic drugs carry substantially greater risks, including dependence, hallucinations and cardiovascular adverse effects due to their stimulant effects on the central nervous system.

Concerns that tighter access through legitimate channels could fuel the distribution of “counterfeit drugs” and drive the market underground are another major argument against the measure. Counterfeit injections have already circulated through social media and illicit markets worldwide amid surging demand for Wegovy and Mounjaro, prompting warnings from the World Health Organization. The industry warns that placing misuse and abuse warnings on packaging and raising barriers to legitimate prescriptions could drive patients toward overseas online purchases or underground distribution channels, potentially resulting in serious safety incidents involving unverified counterfeit medicines.

Critics also argue that the measure would stigmatize obesity treatment and restrict patient access in Korea, running counter to global guidelines that regard obesity as a “chronic metabolic disease requiring lifelong management.”

With the MFDS seeking to push through the notification revision in September, attention is now focused on how the Regulatory Reform Committee will balance health authorities' argument that the designation is needed to block prescription-free sales in exemption areas against industry warnings that it could drive patients back to psychotropic drugs and expand the black market for counterfeit medicines.