Under the government guidance and permission, such harmful drugs are being produced and sold to outsiders in order to bring profit to North Korea. They have no concern about health and lives of people outside North Korea. Free medical care is just a word. If you don't have money, you die. Medicines which have been donated from other countries go into private merchants and are sold at high prices.
Doctors first check patients' wallets before treating.
Medicine are sold at markets but most of them are fakes. Even if you manage to get in, you have to pay for each shots, medicine and food. It simply means that ordinary people are not allowed to be hospitalized. It is hardly enough so many have to keep eating porridge. Poor families cannot send their children to school.