How displaying drug prices could affect healthcare access

The Star

13-05-2025

The drug price display Order under the Price Control and Anti-Profiteering Act (723) was gazetted on April 30 (2025), with an implementation date of May 1 (2025).
Various statements have been made by politicians and non-governmental organisations (NGOs).
The Ministers of Health, and Domestic Trade and Cost of Living, did not mention anything about its negative impacts, which this column will address.
Increased private clinic charges
Compliance with the law requires capital and recurrent expenditure.
The former includes purchase of display modalities like laptop, tablet, board, etc; additional staff costs; and in some situations, renovation costs.
The latter includes replacement of damaged display modalities and additional staff costs for updating the drug prices.
The additional clinic expenditure will ultimately be borne by everyone who seeks healthcare from private clinics.
The reason is simple: private clinics do not get subsidies or tax incentives.
In short, private clinics are not charity organisations and will pass on the cost to their customers (i.e. patients).
Increased healthcare costs
Drugs are dispensed by a private clinic or hospital after a doctor has made a diagnosis of a patient's condition.
The drug(s) prescribed are specific for the individual patient.
For example, certain painkillers will not be prescribed if the patient had side effects from them previously.
No one can purchase drugs from a private clinic or hospital, not even if one has a prescription from another healthcare facility.
The private clinic or hospital will, in accordance with professional practice, only dispense drugs when prescribed by its own doctor(s).
This is because doctors are held accountable for their prescriptions, unlike pharmacists, sundry shops or supermarkets.
If a patient decides to obtain the drug(s) from another private clinic or hospital, the patient has to consult another doctor from that facility.
Needless to say, this will incur additional costs.
If a patient wants to purchase drugs from a retail pharmacy with a doctor's prescription, there are costs of transport and time.
In short, drug price display will increase healthcare costs.
Decrease in outpatient services
A cost-benefit analysis conducted by the Health Ministry in collaboration with the Malaysia Productivity Corporation stated clearly the long-term impact of this move.
It said that over the next 15 years, '2,600 private clinics will likely close, especially smaller clinics, resulting in reduced healthcare access.
'In the short term, private hospitals will shut down outpatient services to stay afloat, and in the long run, may consider leaving the Malaysia market.'
In short, the increased population will have fewer private clinics to go to, thereby reducing access to healthcare.
The above analysis also estimated that about 88,000 job losses in private clinics and that the government will also see reduced income from tax, investment and medical tourism.
The analysis concluded that 'the overall cost-to-benefit ratio is -3.3:1, i.e. for every RM1 saved, around RM3.30 is lost to Malaysia'.
Medication literacy and decision-making
One reason oft cited in favour of drug price display is that it would provide more power to patients by allowing them to make purchasing decisions based on clear price information.
This claim ignores the fact that private clinics and hospitals are not sundry shops or supermarkets where one can walk in and make purchases.
It also ignores the fact that medication literacy in Malaysia is still rudimentary.
This fact is illustrated by a 2020 study done in Penang of consumers' knowledge of a common cause of poisoning in Malaysians, i.e. acetominophen, which was published in the International Journal of Pharma Sciences and Research .
The findings were: 'Majority of the consumers perceived acetaminophen as safe to use (69.1%) and very effective for minor and moderate pain (81.8%).
'Approximately 52% of the consumers agreed that the reduction of maximum pack size of acetaminophen will decrease the risk of overconsumption and poisoning rate, while 73.8% agreed that better product labelling can help to decrease the misuse of acetaminophen.
'Most of the consumers (82.5%) did not know the content of acetaminophen.
'Around 86% of the consumers knew the proper recommended dose of acetaminophen, i.e. 500mg tablet per intake in adults, while 50% knew the correct frequency of intake.
'Only 46% of the consumers were alert about interaction between acetaminophen and alcohol.
'Less than half of the consumers knew that acetaminophen overdose can cause liver injury (26.8%) and may cause fetal death and spontaneous abortion during pregnancy (19.5%).
The authors concluded: 'Knowledge deficits regarding acetaminophen were found among the consumers and prompt educational intervention is needed to address this issue.'
Transparency needed
The Health Ministry provided information about the participation in its Unified Public Consultation (UPC) poll on drug price display and its deputy director-general (Pharmaceutical Services) was reported to have stated: 'We've already conducted stakeholder engagement sessions, and I think from those sessions, it's clear that the majority of stakeholders agree with drug price display.'
However, the ministry did not make available the report of the Regulatory Impact Assessment of drug price display, of which the UPC poll was a part of.
Surely, the public has a right to know, especially when transparency has been a buzzword of both the Health, and Domestic Trade and Cost of Living, Ministries.
Many general practitioners (GPs) have been approached by vendors to purchase applications for drug price display.
Some GPs have reported people demanding to purchase drugs without consulting the doctors.
The negative impact on the patient-doctor relationship has yet to be played out.
It would not be surprising if someone comes along soon with a drug price check application for the public.
A former health minister has stated that 'Malaysia's private primary care pricing is among the most competitive globally and has not been a significant contributor to medical inflation.
'Disrupting this balance may lead to unintended cost burdens on the rakyat.'
In urging the government to defer implementation until a comprehensive reform is undertaken after an in-depth discussion with all stakeholders, the former health minister stated that Malaysia's healthcare financing model requires a broad, structural review, and that 'mandatory drug price displays should be part of a comprehensive reform agenda and not introduced in isolation'.
To ignore the former health minister's warning would be foolhardy, to say the least.
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email [e-mail]. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.