Spell out the Pharmacy Bill details — Narinder Pal Singh

JANUARY 18 — There is talk that the new Pharmacy Bill may be tabled in Parliament within this year.

The pharmacy community, which will be directly affected by it, has been all ears and eyes and wonder what details in the new Bill as the content is still anyone's guess until revealed in Parliament.

Nevertheless, one contentious issue that has haunted pharmacy practitioners is on the dispensing rights being fully accorded to pharmacists and doctors merely prescribe the medications upon diagnosis.

Of course the associations representing medical practitioners here have for long opposed the idea and the tug-of-war between these two professions has been long standing.

While the doctors maintain that they are sufficiently trained and adequately knowledgeable in dispensing medications to their patients, the pharmacists are of the opinion that it would be more advantageous to patients to obtain such from qualified pharmacists.

While both parties have their intellectual arguments made for public consumption, there seem to be a larger practical picture being left out of the entire 'battlefield', and that is what does the public want and what best suits the public?

Let’s not forget that the demographics differ widely in the country and far more in Sabah and Sarawak. We cannot have two sets of rules on everything, can we?

Public consultation on a wider perspective and platform will be paramount to be done to gauge if indeed the public will be comfortable and receptive in the change of the dispensing system. At the current moment, doctors and hospitals double up as a one-stop centre.

Patients get consultation, treatment and medications in the same premise. Will they take to the change as practiced in some countries like Australia, United Kingdom or Canada?

We must also keep in mind thus far there has not been mass complaints from the public with the current practice of obtaining the medications from the clinics or hospitals while the option remains for them to exercise their rights to purchase from a pharmacy if they wish.

There is no element of force or law that will compel them to only purchase their medications from pharmacies.

Though pharmacists have long argued that they are qualified and professional guardians for pharmaceutical care, but unfortunately their arguments have been rather empirical and not based on local and wide ranging hard data to justify that indeed medications errors, morbidity or mortality could be reduced drastically and significantly if separation of dispensing happens here.

Extrapolating external data derived from foreign countries do not give justification that the current system is faulty and that it must be revamped just in order to satisfy a need to toe developed nations.

And what about the element of cost to the patients especially if they are covered by insurance or paid for by their respective companies?

Private entities and insurance companies pick up medical bills for their staff or customer respectively, provided the clinic or hospital is on their panel list where the person sought treatment and medication.

But I have never come across pharmacies being on the panel. Usually those who can claim for medication purchased from a pharmacy are the top level management and they are not the majority from a company.

So how do we go about addressing the issue of making claims, separately from the fees imposed by clinics and hospitals? Do patients pay first and claim later – which could put more financial burden on them as they have to wait to get their monies?

Will this system be more friendly to them as compared to now? Will private entities then subject their employees to only purchase their medications from certain mega-pharmacies, depriving stand-alone businesses a fair share of the market?

Monopoly by big players in the community pharmacy practice on all facets could set in very easily, phasing out the more competitive independent outlets.

Above that insurance companies are extremely sticky with medical claims and even super medical consultants are queried for the type of treatment they dispense to their patients before monies are released.

How then do we tackle the insurance companies on just the medication part of the patient since there is lack of a centralised monitoring, disbursing of claims and registry for patients in Malaysia? Even the government hospitals do not have a practical centralised system throughout the country.

We do not have a National Health System that could hook up even independent pharmacies to the grid for systematic dispensing of medication and for reimbursement purposes.

Though the idea of separating the two functions sounds noble and done in the name of public interest, we must not ignore that a fragmented approach could be disastrous in time.

This is not to say that one profession is superior to the other as they stand correct in their own territory, but when it comes to the general public domain, it is shared and their care supercedes any single ego.

Rushing into a policy only to make a U-turn later would eventually burden the tax payers that are already stretched for every cent in current times.

So, to policy-makers, please scrutinise all segments and contributing parameters thoroughly and objectively from all perspectives before implementing any change and not rely on academic forces.

* This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.

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