PUTRAJAYA, Jan 9 — A pharmaceutical group has urged the government to look at other factors like clinical needs in the procurement of medicines, instead of focusing solely on price.

The Pharmaceutical Association of Malaysia (PhAMA) said the Health Ministry should use other methods besides reference pricing so that it can achieve cost savings and safeguard access to medicines at the same time.

There are two types of reference pricing: International reference pricing refers to using the price of a medicine in another country as a benchmark to negotiate the price of that drug in one’s country, while internal reference pricing is used to promote generic drugs.


“While MoH has a Drug Formulary Listing, the range of availability and the uptake of drugs in the public sector remain limited,” PhAMA said, referring to the Health Ministry, in its Advancing the Health of a Forward Moving Nation 2018 industry fact book that was launched here yesterday.

“Surveys have found that Malaysians’ access to innovative medicines was consistently lower than those of Koreans and Taiwanese.”

PhAMA pointed out that according to 2014 data, only 0.4 per cent of patients in Malaysia had access to a treatment for Type 2 diabetes called DPP-IV inhibitors, much lower than 9.8 per cent and 10.8 per cent for patients in Korea and Taiwan respectively.


Only 0.21 per cent of Malaysian patients had access to biological therapies for rheumatoid arthritis, compared to 4.92 per cent in Korea and 9.2 per cent in Taiwan.

“PhAMA believes that a mutual goal of providing equitable and sustainable access to innovative medicines would be of tremendous advantage to the public, the government, and other relevant stakeholders.

President of Pharmaceutical Association of Malaysia Chin Keat Chyuan speaks during the launch of the PhaMA Industry Fact Book in Putrajaya January 8, 2019. — Picture by Miera Zulyana
President of Pharmaceutical Association of Malaysia Chin Keat Chyuan speaks during the launch of the PhaMA Industry Fact Book in Putrajaya January 8, 2019. — Picture by Miera Zulyana

“The institution of a united network of stakeholders to work towards this goal, utilising a multi-criteria decision analysis (MCDA) model, to increase transparency and predictability of decisions, is thus recommended,” said PhAMA.

MCDA uses multiple criteria in healthcare decision-making, instead of using a single factor like cost effectiveness.

PhAMA previously noted in a 2016 paper on value pricing that many innovative medicines have not been listed on the national formulary — which lists the medicines provided in MOH hospitals here — in the last few years, claiming that this has led to high out-of-pocket (OOP) costs for patients.

The association said in its fact book that 40 per cent of an average person’s total healthcare expenditure in 2016 in Malaysia comprised OOP payments.

“Interestingly, the pricing of medicines in Malaysia are, in fact, not significantly higher than that of our neighbouring countries, even when branded innovative medicines in high-cost therapeutic areas such as oncology is taken into consideration,” PhAMA added.

Malaysia only spent 4.2 per cent of its gross domestic product on total health expenditure in 2014 (2.3 per cent was on public healthcare), well below the average of 6.2 per cent in upper-middle income countries. But the Pakatan Harapan government increased the health care budget to RM29 billion for Budget 2019, up by 7.8 per cent from the previous year.

PhAMA also said in its factbook that its member companies were expected to introduce 156 prescription-only medicines between 2017 and 2022, with cancer treatments topping the list.

“As Malaysia continues to see a rising prevalence of cancer, PhAMA members are responding proactively by increasing the public’s accessibility to innovative cancer medicines, as demonstrated by the number of anticancer agents introduced into the country,” said PhAMA.

Twenty-four anticancer agents will be launched between 2017 and 2022.

PhAMA comprises importers, distributors and manufacturers of medicines.