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MMA’s Response to Survey on Drug Pricing 3 April 2007 The report of the drug price survey in the News Straits Times Press dated 28 March 2007 is highly misleading. It is frivolous to suggest that the providers of health care are profiting at the expense of the public. Primary care in the private sector health care especially at the primary care level is definitely the most affordable in this region, even globally, when compared to level of national income and development. The Malaysian Medical Association (MMA) feels that it is important to view the report in the context of overall access and affordability. Doctors provide a comprehensive service of consultation and dispensing for the convenience of their patients. In most places, the total cost of a visit is much less than the scheduled consultation rates in the Private Healthcare Facilities and Services Act 1998. In most cases, the private general practitioners’ charges include medicines dispensed. The public can also request only for the consultation and get a prescription to purchase in any pharmacy. Most will accept that they are paying for the professional services and not just the product that the doctor prescribes and dispenses. The ultimate value of the service is primarily the consultation and examination with the benefit of the expertise and clinical experience of the doctor. We should also consider the opportunity costs factoring in time and distance as issues of access to primary care. If one opts not to go to the ‘zero cost’ public facilities, there is the neighbourhood general practice, where one can be generally be seen within an hour without any prior appointment. In most developed countries, patients generally have to be registered with their general practitioners (GPs). In the UK, the NHS provides a specific GP and even then one has to ring for an appointment based on priority. In Malaysia, the doctor is usually the person who has to wait for patients. In Malaysia, private general practitioners are open in all areas and it is possible to find a service around the clock except in the smallest towns. These general practitioners provide a one stop service without any access barriers. The doctor in late night clinics is often at risk of crime and every practitioner has to maintain staff, premises and current drug inventory at own cost. A study on drug pricing should factor all these real world costs rather than isolating and highlighting only one narrow aspect of access. The universal effect of health policies and politics has regrettably been to diminish the role of the primary care practitioner. In essence, the primary care practitioner forms the axis and foundation of a good quality health care system. The MMA would like to recommend that each person have their own preferred primary care physician to ensure continuity of care. The choice is up to each individual and if the service or prices are not to satisfaction, remedial action is always an easy option.
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