I REFER to the statement by the health minister that his ministry will work with the Ministry of Domestic Trade and Consumer Affairs to regulate prices of medicines.
Since 2017, the Association of Private Hospitals of Malaysia (APHM) has been in discussion with the Pharmaceutical Services Division of MOH on the proposed move.
The APHM is concerned about the minister’s statement that price ceilings will be imposed at two points, one at the whole sale level and the other at retail level ie at the clinics, pharmacies and hospitals.
The APHM puts on record that it is not in support of any proposed move that seeks to control the prices of medicines in private hospitals.
First, in a hospital setting, medication is administered as part of the care rendered to patients. Unlike straightforward dispensing at retail pharmacy, medication administration involves other costs such as medication review, drug counselling, compliance monitoring, titration of dosage as patient’s condition change, etc.
There are a host of direct and indirect costs associated with it, which varies across private hospitals depending on their locations, level of service and specialities.
We have cautioned against a blunt policy that disregards this cost variance and had brought this up with the Pharmaceutical Services Division at a town hall meeting on Feb 28. We were given an undertaking it would be considered.
Next, any such policy and regulatory measures would have to be made in tandem with the overall payment system.
Currently, much of a private hospital’s direct and indirect costs are lumped into a few chargeable items, and medication services is one of these. This was the result of a distorted payment structure for private healthcare where proposals to realign increases in these costs to their proper categories – such as room and board rates – were met with resistance.
The increases were inevitable due to factors such as inflation, exchange rates and higher manpower requirements.
A unilateral move to regulate the prices of medication services in private hospitals without a concerted move to realign the payment system will impair the viability of private hospitals and suffocate the capacity in the private healthcare sector to complement the government sector in meeting the healthcare needs of Malaysians
We fully support the push for greater transparency and efforts to rein in medical inflation. However, this has to be thought through carefully to avoid unintended policy outcome that would hurt Malaysia. A piecemeal approach without considering the entire healthcare financing structure and without the involvement and cooperation of the payors would ultimately collapse the Malaysian private healthcare sector.
Datuk Dr Kuljit Singh
President
Association of Private Hospitals of Malaysia
