'Dispensary role has benefits but access remains a concern'

New Straits Times

06-05-2025

ALOR STAR: Granting pharmacists full dispensary rights could reduce unnecessary patient spending and improve healthcare efficiency — but only if implemented carefully with accessibility in mind, says a health economics expert.
Associate Professor Dr Shamzaeffa Samsudin of Universiti Utara Malaysia's School of Economics, Finance and Banking said the separation of prescribing and dispensing roles combined at most private clinics could help curb overprescription.
"The main benefit, from a health economics standpoint, is that it could reduce moral hazards among doctors in prescribing.
"There have been cases where unnecessary medicines are prescribed, especially at clinics with in-house pharmacies. Separating the two roles may help address that," she told the New Straits Times.
She said irrational or excessive prescriptions contributed to rising healthcare costs for patients — an issue the separation policy could potentially resolve.
However, Shamzaeffa warned that any move must also consider practical realities for patients.
"On one hand, yes, it may lower spending. But on the other, it could place an additional burden on patients."
She said many Malaysians still preferred the convenience of receiving both consultation and medication under one roof, especially in semi-urban and rural areas. Requiring patients to visit an external pharmacy could add transport and logistical challenges.
"In terms of easing congestion in healthcare, the idea works on paper. It allows doctors and pharmacists to focus on their core responsibilities.
"But, at the same time, some patients are willing to pay more for the convenience of getting everything done at one location."
She added that if the separation model were to be introduced, it must be accompanied by efforts to ensure pharmacies are available and accessible nationwide.
Beyond costs and logistics, Shamzaeffa said such a reform could raise the status and welfare of pharmacists, aligning with Malaysia's ambition of building a modern, efficient healthcare system.
"As we move towards becoming a developed nation, we must acknowledge the distinct expertise each healthcare professional brings. But ultimately, access to affordable and convenient healthcare must remain the priority.
"If separation can be implemented without burdening the public, then it's worth pursuing — not just to support the pharmacy profession, but also to improve patient outcomes."
Galen Centre for Health and Social Policy chief executive officer Azrul Mohd Khalib agreed that separating prescribing and dispensing could bring benefits.
"Doctors would no longer have a financial incentive to overprescribe, medicine prices would become more transparent and competitive and general practitioners (GPs) could focus more on clinical work."
He said similar systems were already in place Japan, South Korea and Taiwan.
However, he cautioned against rushing the process as poorly managed rollout could increase pressure on government clinics and lead to the closure of private GP practices.
"This would be an inconvenience to patients, especially those who rely on late-night or early-morning visits to clinics that also dispense medication.
"Patients may have to wait for pharmacies to open just to get their prescriptions filled. That's a major shift from the convenience they're used to," he added.
Consumers Association of Penang president Mohideen Abdul Kader echoed similar views, calling for the reform to be rolled out gradually.
He said the association supported the separation of dispensing responsibilities in principle, as it could help clarify the distinct roles of doctors and pharmacists.
"The system should only be introduced in towns with enough pharmacies near clinics and hospitals."
Mohideen said the government must implement the move in phases, stressing that while convenience was important, the current arrangement carries a potential conflict of interest that needs to be addressed.