The Health August 2023 | Page 9

AUGUST , 2023 | THE HEALTH

Another reason for the rising cost of medications / drugs , he said , would be due to patent exclusivity protection at level 2 of the supply chain , in which there is no competition .

“ This has a significant impact on the price of medicine which is influenced by the innovator with monopoly power of patent holders .

“ Before the expiration of the IP protection of patented medicines , the industry players can enjoy their dominance by imposing a high price on the medication as part of their investments / profit before facing competition from the generic alternatives .

“ In addition to the patent exclusivity issue , there may be cases of ‘ pay-for-delay ’ agreements between originators and generic companies which occurs when the patent holder pays its competitors to delay the introduction of a competing drug .

“ As a result , the generic manufacturer agrees to postpone its entry into the market in exchange for compensation , leading to the continuous expensive price of the medicines ,” said Iskandar .

In addition , mergers and acquisitions activities amongst certain players in the relevant market in Malaysia might limit generic competition as there would be lesser industry players in the market . The effect would be the potential for price hikes of the medicine , making it unaffordable to consumers . It will also cause the abandonment of the development of new medicines .

GOVERNMENT PROCUREMENT POLICY

Various measures have been taken to ensure that medicines are always available in MoH facilities , assured Dr Radzi .

“ One of them is to prioritise the procurement of generic medicines in accordance with the generic drug policy as stated in the Malaysian National Medicines Policy ( DUNAS ).

“ When awarding contracts , procurement principles such as

This is evident from the Ministry of Health ’ s ( MoH ’ s ) annual expenditure on medicines , which has increased . The increase in medicine prices and a rise in the number of patients significantly contribute to this increase in expenditure . The elevated cost of medicines impacts the procurement process and the selection of drugs for treating diseases .”

– Datuk Dr Radzi Abu Hassan

accountability , transparency , value for money , open and fair competition , and fair trade require bidders to meet specific requirements .

“ Price negotiation is initiated when there is no competition in the market or when the price of products is too high . The goal is to achieve better prices , country access , and ample patient supply .”

Amrahi emphasised that DUNAS is an important policy within the health system , especially regarding access and affordability of medicines to the population .

MoH facilities , he said , also play a role in ensuring that there is no interruption in the supply of medicines to patients by carrying out internal control and continuous planning to ensure that the supply of medications is sufficient .

Dr Radzi added : " Nevertheless , among 293 government tender items , 64.8 per cent of medicines experienced price reduction due to improvement in government procurement policy with comprehensive pricing evaluation and negotiation . The government policy promoting generic medicines supplemented the price reduction .”

Amrahi Buang

THE WORLD Health Assembly ’ s ( WHA ) Resolution on “ Improving the transparency of markets for medicines , vaccines , and other health products ” was adopted in May 2019 , with Malaysia supporting it as a member state .

Director-General of Health Datuk Dr Radzi Abu Hassan said : “ The MoH is currently proposing the Medicines Price Transparency Mechanism ( MKHU ) to improve the transparency of medicines price information .

“ In line with the Government ’ s commitment to overcoming the rising cost of living , the Executive Committee of the National Action Council on Cost of Living ( NACCOL ) on May 16 , 2023 , has also agreed on implementing the initial phase of MKHU to increase the transparency of medicines prices .” The low-hanging fruits agreed upon include sharing medicines prices by the pharmaceutical industry with the Ministry of Health ( MoH ) and the display of selling prices of medicines by health facilities such as private clinics , private hospitals and community pharmacies .

“ The MoH and the Ministry of Domestic Trade and Consumer Affairs will continue to discuss and work together on the implementation timeline and associated regulations .

“ The Government is committed to continuously engaging with various stakeholders , including consumers and industries , to increase awareness of MKHU .”

THE ROLE OF PHARMACISTS IN CURTAILING RISING COSTS

Most countries around the world have coherent pricing policies and transparent medicines pricing . For example , South Africa has the Single Exit Price system , where prices at all levels of the supply chain are controlled and made transparent to the public .

Other regional countries such as Indonesia , Thailand , South Korea and Australia have health insurance systems where medicine prices at selected levels of the supply chain are made transparent .

According to the Federation of Malaysian Consumers Associations ( FOMCA ) President Datuk Dr Marimuthu Nadason , ensuring transparency in pricing by pharmaceutical companies and suppliers can empower consumers to make informed decisions about their healthcare purchases and put pressure on entities with unjustified price hikes .

Meanwhile , Malaysian Pharmacists Society ( MPS ) President Amrahi Buang suggests that the Domestic Trade Ministry play a significant role in addressing the issue of medicines and drug pricing using the Rahman and Madani concepts .

He said pharmacists also play an important role in helping curtail the rising cost of medications .

“ They can help contain the rising cost by ensuring consumers buy and use medications and drugs based on needs , there is no panic buying , display prices ( transparency ), build trust with consumers and lastly , prioritising value versus cost benefits ( professionalism ).”

In alleviating the burden of pharmacists in improving access to preventive medications and care , he said the Health White Paper is an excellent framework .

“ The focus now is on preventive and promotive care rather than curative , rehabilitative and palliative care .

“ Community pharmacies also play a significant role in primary care as they are the most accessible healthcare providers in the community setting . The MySejahtera App should include the location of community pharmacies throughout the country .”