Tuesday, February 17, 2015

Pharmacies to dispense medicines if proposal accepted

Pharmacies to dispense medicines if proposal accepted

PETALING JAYA: Instead of getting their medicine from private clinics, patients will have to obtain it from pharmacies if the Health Ministry accepts the proposed “Doc­tors diagnose, pharmacists dispense” system.

While the system may cause some inconvenience to patients, pharmacists say it will help bring down the prices of medicine and give doctors access to many more drugs to prescribe.

It is learnt that doctors and pharmacists have held several discussions on the issue over the last year and they plan to meet the Health Minister soon.

They are represented by the Malaysian Medical Association (MMA), Medical Practitioners Coalition Association of Ma­­lay­­sia, Islamic Medical Association of Ma­­­laysia, Malaysian Pharmaceutical So­­ciety (MPS) and Malaysian Community Phar­­macy Guild (MCPG).

According to MCPG president Wong Sie Sing, the five organisations had, at their last meeting on Nov 8, agreed in principle that dispensing be left to pharmacists.

Representatives of pharmacists later met Health Ministry director-general Datuk Dr Noor Hisham Abdul­lah on Nov 26.

He said the two professions met to work out a timeframe to introduce the new system, adding: “I hope we can implement it by April.” Debate on the issue has been going on from as far back as 2008.
“If pharmacists are allowed to dispense, doctors would have access to 10 times more drugs to prescribe than what they have in stock. This will benefit the patients,” Wong said.

MCPG represents more than 2,000 community pharmacies employing some 2,500 pharmacists.

MPS president Datuk Nancy Ho said patients would receive further counselling from another group of well-trained healthcare professionals if pharmacists were to dis­­pense medication.

“The check-and-balance reduces prescription and dispensing errors. Dispensing separation is about professional medication management and only pharmacists are trained in this specialised practice. We know everything about a drug’s healing value and possible harm,” she said.

MMA president Dr H. Krishna Kumar confirmed that the associations had met on the proposed new system but said nothing had been agreed on yet.

Dr Noor Hisham confirmed meeting representatives of pharmacists, and said they discussed about integrating and consolidating the Pharmacy Act.
Stating that nothing had been decided on, he stressed that the ministry’s main priority was to ensure quality and safety.

Universiti Sains Malaysia (School of Phar­maceutical Sciences) Assoc Prof Mohamed Azmi Ahmad Hasalli said a 2013 study of 40 clinics and 100 pharmacies in Penang found that doctors dispensed more medicine and antibiotics and charged more than pharmacists.

Separation of dispensing rights will raise cost

MALAYSIANS are learning to adapt to rising prices all round, including the added burden of the impending Goods and Services Tax (GST).

Thus it is surprising that there are vested parties wanting and demanding to separate dispensing rights from doctors.

The one-stop consultation and dispensing of medicines by general practitioners has kept the price of healthcare affordable.

This time-tested practice has existed in Malaysia for more than a century.

Doctors package the cost of a visit to a GP on an average of RM50, which includes medicine and consultation.

If separation is done, the average cost will balloon many times more.

The GP then will have to charge RM30 to RM50 for consultation alone as approved by the Health Ministry Fee Schedule.

Patients will have to look for a pharmacy after consultation with a GP, to get the medicines of his prescription from the pharmacies. This will make healthcare unaffordable for most Malaysians.

GP clinics are easily accessible. There are probably more GP clinics than post offices or police stations in Malaysia. GP clinics exist even in remote corners of the country, including Sabah and Sarawak. Many GP clinics operate a 24-hour service.

Pharmacies are few especially in the rural areas. None offers round- the-clock services even in urban areas.

Most Malaysians prefer and have used this one-stop service without any complaints. Why change a system that works and keeps all happy?

Malaysia is known to have the most affordable private primary healthcare system in the world.

Let us not lose this hard won international accolade due to pressure and lobbying by those having financial self-interest.

Malaysians will have to pay a heavy price for this change if it ever becomes a reality.

They hope the Government will not yield to this “bullying” by the concerned parties to separate dispensing from doctors.

DATUK DR NKS THARMASEELAN
Malacca


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