Saturday, March 29, 2008

Finally, the hope may come true! Dispensing Separation

Doctors to be disallowed from dispensing medicines
By : Annie Freeda Cruez
Soon only pharmacies will  dispense medicines while  doctors can only prescribe medication.
Soon only pharmacies will dispense medicines while doctors can only prescribe medication.

KUALA LUMPUR: Soon, doctors will not be allowed to dispense medicines. Doctors will only be allowed to prescribe medications but patients will have to get the medicines from pharmacies.

Currently, doctors diagnose the disease, prescribe the medicines and their own clinics dispense them.

For almost 20 years, pharmacists have been fighting for the "return" of their right to dispense medications but had been unsuccessful for various reasons.

A pilot project on the separation of functions between doctors' clinics and pharmacies will be launched by the Ministry of Health.

It is scheduled to be launched at selected major towns with the ministry closely monitoring the strength and weaknesses of the system before implementing it nationwide.
Director-General of Health Tan Sri Dr Ismail Merican said the ministry was not able to implement this system earlier due to logistics problems, especially the shortage of pharmacists and pharmacies in the country.

"We also have to take into consideration the welfare of patients. If we have the separation, then patients must have easy accessibility to pharmacies to get their prescribed medications," he told the New Straits Times.

He said the ministry had conducted a detailed study, "Pharmacy and clinic Mapping" on various issues ranging from welfare of patients, facilities available and capability of pharmacies to meet the demand.

"We found that the logistics problem is still an issue and needs to be resolved as we do not want patients to be running around looking for pharmacies with the doctors' prescriptions," said Dr Ismail.

Furthermore, he said, the pharmacies should be able to provide quality care.

He said the ministry had been doing the study with various stakeholders, focusing on the spread of community pharmacies or pharmacy outlets in major towns, rural and remote areas.

Some 5,000 registered pharmacists are actively practising in some 1,600 pharmacies nationwide.

In 2004, there were only 3,927 registered pharmacists with about 1,540 retail pharmacies or one for every 16,445 persons.

Dr Ismail said the pilot project would be implemented in major towns based on the study where there were pharmacies near clinics.

"If the pilot project is successful, we will have to look into the existing laws to allow for the separation," he added.

India, South Korea and Taiwan have implemented the separation. Malaysian Pharmaceutical Society president John Chang Chiew Pheng said the ministry's move to conduct a pilot project was definitely a positive development which would enhance the level of healthcare delivery.

The separation, he added, would benefit patients as doctors could now focus on their clinical, diagnosing, counselling and prescription, while pharmacists could focus on educating patients on how best to optimise the usage of medicines prescribed.

Furthermore, Chang said, pharmacists could help patients choose between generic and branded drugs based on their financial situation.

"With commitment and determination we can overcome teething problems and patients can understand their medicines," he added.

He said if the government went ahead with the separation, then more pharmacies could be set up near clinics for easy accessibility to patients.
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Ask the Pharmacist

1) I hope the health minister (they said the position is cursed) can stay long enough to implement this.
2) It only stated "SOON", but we do not know when. Today is 29/03/2008. Let see when it is going to be implemented and see how long is the "soon" .
3) Does writing to PM work? It seems someone do take note. I am not dreaming.
4) What a happy news....HAHAHA

7 comments:

Ted said...

Finally, a step in the right direction.


The PM has yet to answer my letter to him though.

pharmalogik said...

2008/03/29
MMA opposes move to make pharmacist sole dispensing agents

The Malaysian Medical Association (MMA) will oppose a move by the Health Ministry to make pharmacists the sole dispensing agents in the country.
Its president, Datuk Dr Khoo Kah Lin, said based on the ministry’s statistics in 2006, the pharmacist-population ratio in the public sector is 1:29,966, the private sector 1:7,828 and the total ratio is 1:6,207.

He said MMA felt that the public should be left to decide from where they wanted to obtain medication, either from a doctor or pharmacist.

“In helping them to make such a choice, the public need to have all the facts regarding the present position, their advantages and disadvantages and the costs to them as individuals and a community, if the system is to be changed,” he said in a statement here today.

Yesterday, Director-General of Health Tan Sri Dr Ismail Merican said soon, doctors would only be allowed to issue Rx-prescribe medications but patients needed to obtain their medication from pharmacies.
Currently, doctors especially at private clinics diagnose diseases, prescribe medicines and dispense them to patients.

Dr Khoo said some local manufacturers did not use the same base substance as the original patented drug.

“Thus, although the amount of active substance is the same, the potency and duration of action may differ...so may the shelf life of the drug.

“This is the main reason most doctors still prefer to use patented medicine, not because we want to gain profit or get incentives,” he said.

Dr Khoo said if the proposal shot off prematurely, patients would face the inconvenience of having to travel to another location to buy the medicine prescribed by the doctor.

He said if there was to be change, it should be made gradually beginning with the larger towns, and pilot studies should be considered so that problems that arise could be ironed out.

“In the meantime, both professions (doctor and pharmacist), together with the ministry could look at this problem objectively and solve it amicably, keeping in mind the interest of patients,” he said. — BERNAMA

pharmalogik said...

Move will not necessarily cost patients more

KUALA LUMPUR: Contrary to public perception, separating the doctor's function as a healer and as a provider of medicine will not necessarily cost patients more.
Malaysian Pharmaceutical Society president John Chang Chiew Pheng said this was because consumers would have the choice of drugs.

"Many doctors usually dispense the more branded and expensive medicines simply because they get incentives and bonuses from the drug companies.

"When the consumers get their medication and make up their minds whether to get branded or generic drugs, they end up saving money.

"The Poisons Act 1952 allows for doctors to dispense drugs because there were hardly any pharmacists when the law was passed," he said.
There are now roughly 5,000 pharmacists and 13 pharmacy schools in the country that produce an average of 600 graduates every year.

Chang also said that with serious risks to health due to improper medication, it made better sense for patients to get their drugs from a pharmacist who would have spent four years acquiring the knowledge than from a doctor who had none.

"Doctors are only familiar with medicines that they often prescribe, not knowing adverse reactions and drug interactions. However, pharmacists are constantly in touch with the drugs industry," he said.

With the separation of functions between clinics and pharmacies, Malaysia will join the ranks of other developed countries around the world which separate the role of doctors and pharmacists.

In the last 30 years, Asian countries like Japan, South Korea, Taiwan, the Philippines and Indonesia have implemented the separation with varying degrees of success.

When South Korean health officials enforced the separation in 2000, tens of thousands of doctors took to the streets and forced clinics around the country to close for three days.

The various countries also experienced teething problems such as administrational confusion when charging corporate patients seeking treatment in panel clinics or claiming health insurance.

Separation laws in several countries also had loopholes, abused by pharmacists who were in cahoots with doctors for patient referrals in exchange for kickbacks.

All this, Chang admitted, could very well also happen in Malaysia if the separation was not closely enforced and scrutinised.

pharmalogik said...

The Star:
No decision on docs dispensing medicine
By TEH ENG HOCK

KUALA LUMPUR: The Health Ministry has denied a report which said doctors would be prevented from dispensing medicine.

Health Minister Datuk Liow Tiong Lai said the article, which was published on the front page of a local English daily on Saturday, was not true.

"We have not made any decision at all. We are conducting a study, but it is only at a preliminary stage," he said.

The report said a pilot project on the separation of functions between doctors' clinics and pharmacies would be launched by the Health Ministry.

It also said that the pilot project would be launched at selected major towns, with the ministry closely monitoring the strengths and weaknesses of the system before implementing it nationwide.

Liow said while the Ministry was considering the request by pharmacists, the study had yet to be completed and a pilot project might not even be launched if the findings were not encouraging.

"If we find that people will be affected (negatively), we might not even carry out the pilot project," he said.

He added that he wanted to meet up with doctors and pharmacists to understand more about the issue.

"But most importantly, at the end of the day, the people must enjoy good medical services," he said.

Liow was speaking to reporters after visiting the Kuala Lumpur General Hospital on Saturday.

Ted said...

Sure there will be lots of resistance and debate about this issue

Pang Wee Siang said...

I strongly agree, dispensing should be separated.

Anonymous said...

i'm a 1st year pharmacy student in a local university.from what i learnt/read,the DS should be done.we can function fully with our qualification,considering the 4 years of learning focused on drugs only,unlike doctors.great post