This study looked at the formation process of North Korea's pharmaceutical production system based on datadisclosed by the North between 1945 and 2017 in order to find ways to cooperate in the inter-Korean cooperation era. Since1945, North Korea has established the principle of free treatment and free supply of medicines, and has organized state –owned pharmaceutical factories and drug dispensaries to supply pharmaceuticals to national health care institutions first. Aslarge-scale pharmaceutical plants and small and medium-sized pharmaceutical factories were established by region, and drugdistribution centers were expanded, the basic demand for pharmaceuticals was finally met in 1980. However, as the internationalenvironment deteriorated since 1990, the nation has been unable to produce and supply medicines, and patientshave been procuring their own medicines through market systems. After Kim Jong Eun's inauguration in 2012, North Koreais trying to recover to the mid-1980s through reconstruction of the self-sustaining structure and acquisition of foreign currencythrough development and production of Koryo Pharmaceutical. It is necessary to prepare for the mutual benefit ofthe North and South in the field of medicine supply through inter-Korean exchange cooperation based on the understandingof reality of North Korea.