In Seoul’s Jongno 5-ga district—often dubbed the “holy land” for hair-loss and weight-loss medications—patients continue to pour into clinics and pharmacies, even on weekday mornings. Prescriptions are issued almost instantly. In some cases, doctors write them before patients have fully taken their seats, ending consultations in seconds. From registration to payment, the entire process can take less than two minutes.
“I came early because I thought it would get even more crowded once health insurance is applied,” said an office worker in their 30s visiting the area for the first time. “I was here as a preventive measure, but I didn’t expect it to be this easy.” Similar scenes were observed at nearby clinics known for prescribing weight-loss drugs.
The rush follows President Lee Jae-myung’s recent order to review the inclusion of hair-loss and weight-loss medications under South Korea’s national health insurance system. His remarks have ignited both hope and concern, reopening a long-running debate over whether conditions like alopecia and obesity should be treated as diseases eligible for coverage—or whether such a move would strain already fragile insurance finances.
A Policy Sparked at the Top
The discussion gained momentum on December 16, when President Lee raised the issue during a briefing by the Ministry of Health and Welfare. During his presidential campaign, he had already pledged to expand insurance coverage for hair-loss treatments.
Currently, health insurance applies only in limited cases. Alopecia areata caused by autoimmune disorders is classified as an immune disease, with treatments such as steroids covered. Hair loss linked to aging or genetics, however, remains excluded. Similarly, while surgery for severe obesity is insured, widely used drug therapies—such as GLP-1 medications including Wegovy and Mounjaro—are not.
At pharmacies around Jongno 5-ga, monthly costs for weight-loss drugs range from 300,000 to 500,000 won, depending on dosage. Hair-loss medications vary widely by manufacturer and whether they are generic, costing roughly 100,000 to 500,000 won annually.
Public Opinion: Prevention vs. Boundaries
Public reaction remains sharply divided. Some argue that insurance coverage is most effective at the prevention stage. “Both hair loss and obesity are easier to manage early on,” said a 28-year-old office worker taking preventive hair-loss medication. “Even partial coverage would significantly reduce the burden.”
Others urge caution. A 32-year-old patient prescribed weight-loss medication said, “We need clear standards to separate cosmetic use from medical treatment. Coverage should be limited to cases that meet objective criteria, like BMI thresholds.”
Fears of Overprescribing and Fiscal Strain
Critics warn that insurance coverage could worsen an already controversial culture of overprescribing. “Misuse and overuse are already problems,” said a 34-year-old office worker. “If these drugs are covered, people will take them more freely and in larger amounts.”
Pharmacists echo these concerns, pointing to the financial sustainability of the health insurance system. “With costs already rising due to aging and chronic diseases, it’s unrealistic to subsidize treatments perceived as cosmetic for younger populations,” said a pharmacist in Jongno 5-ga. “Premium increases would likely be unavoidable.”
According to projections by the Korea Institute for Health and Social Affairs, even if the insurance premium rate reaches its legal ceiling of 8%, annual spending could outpace revenue by more than 44 trillion won by 2050. Estimates suggest that if half of Korea’s roughly 10 million people experiencing hair loss and 18 million people classified as obese became eligible for coverage, annual insurance costs could reach 24 trillion won.
Weight-loss drugs raise additional concerns because discontinuation often leads to weight regain, potentially locking patients into long-term or lifelong use. “Classifying these medications as insured benefits conflicts with the core principles of the system,” another pharmacist noted.
Government Signals Caution, Looks Abroad
The government has struck a measured tone. Health and Welfare Minister Jung Eun-kyeong acknowledged that covering genetic hair loss could significantly affect insurance finances, saying the ministry would “comprehensively analyze the fiscal impact.”
International examples suggest a cautious path. In Japan, insurance coverage for weight-loss drugs is limited to patients with a BMI of 35 or higher, or a BMI of at least 27 accompanied by multiple obesity-related conditions such as hypertension, dyslipidemia, or type 2 diabetes.
Some experts argue that selective coverage could ultimately reduce long-term medical costs. Nam Ga-eun, a professor of family medicine at Korea University Guro Hospital, noted in a recent report that while short-term fiscal pressure is unavoidable, preventing obesity-related complications could lead to savings over time.
As the debate continues, Jongno 5-ga’s clinics remain busy—offering a glimpse of how policy changes, if enacted, could rapidly reshape patient behavior and the nation’s health insurance system.
