Drug price display – at what price?
IN a healthcare system stretched by inflation and frayed by mistrust, Malaysia's new ruling mandating the display of drug prices in private clinics and hospitals is more than a regulatory update – it's a flashpoint in a long-brewing debate over fairness, access, and survival in medicine.
Effective May 1, the law – gazetted under the Price Control and Anti-Profiteering Act – requires all private healthcare providers to clearly display medicine prices.
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New Straits Times
27-05-2025
- New Straits Times
MMA calls for clear legal framework on medicine pricing
KUALA LUMPUR: The Malaysian Medical Association (MMA) has urged the government to act swiftly on issues affecting private general practitioners (GPs), stressing the need for clear legal frameworks and fair consultation fees to ensure the sustainability of Malaysia's primary healthcare system. MMA president Datuk Dr Kalwinder Singh Khaira said the association looks forward to the government's firm decisions following its joint memorandum submitted to Prime Minister Datuk Seri Anwar Ibrahim earlier this month. He said among the top concerns were the appropriate regulation of medicine price display policies and the long-overdue revision of GP consultation fees. He welcomed Health Minister Datuk Seri Dr Dzulkefly Ahmad commitment to place the medicine price display policy under the Private Healthcare Facilities and Services Act 1998, a move the MMA has long advocated, rather than the Price Control and Anti-Profiteering Act 2011, which was never designed to regulate professional healthcare services. "To avoid disputes and legal ambiguities that may arise from overlapping legislation, the government must immediately de-gazette clinics from the Price Control and Anti-Profiteering Act 2011 (Act 723) once the decision is made to place the medicine price display policy under the Private Healthcare Facilities and Services Act 1998 (Act 586). "Keeping clinics under the Price Control and Anti-Profiteering Act after the policy shift would only create unnecessary legal ambiguity," he said in a statement. He said the government must act swiftly to ensure regulatory clarity and prevent jurisdictional overlap by formally de-gazetting clinics from Anti-Profiteering Act 2011 once the other Act comes into effect. "While doctors fully support price transparency, we strongly maintain that all healthcare-related policies must be implemented and enforced under the purview of the Health Ministry (MOH). "While we respect the Domestic Trade and Cost of Living Ministry's role in regulating the retail sector, it is important to recognise that healthcare is not retail." He said clinics provide essential, expert-driven services built on trust and ethical duty, not commercial transactions. Applying retail-based policies to medical practice risks compromising the quality and integrity of care Malaysians deserve, he said. Dr Kalwinder also called on the government to address the longstanding issue of stagnant consultation fees for private GPs. He said fees under the 7th Schedule of Act 586 have remained unchanged for over 33 years, despite significant increases in operating costs. "GP clinics are the front line of Malaysia's primary healthcare system. "For them to remain viable and continue delivering quality care, consultation fees must be reviewed and adjusted to reflect current realities," he said. He said the MMA has submitted a detailed proposal justifying the fee revision and hopes for a fair outcome that supports the long-term sustainability of private clinics. "These issues must not be delayed.
The Star
13-05-2025
- The Star
How displaying drug prices could affect healthcare access
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 starhealth@ 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.
New Straits Times
11-05-2025
- New Straits Times
NST Leader: Of GPs and consultation fees
THIRTY-THREE years make a generation, and that is how long ago private general practitioners (GPs) got their consultation fees last reviewed. For that long the fees have been stagnant at RM10 to RM35, says the Malaysian Medical Association. This can't be right. We pay our plumbers many times more. May be even our barbers. Six years of medical school education must mean something, not to mention a year or two spent as a houseman. On May 6, the GPs gathered at Putrajaya to peacefully protest against a new government directive requiring the mandatory display of drug prices, which they claim was done without consulting them. This contradicts a statement by Health Minister Datuk Seri Dr Dzulkefly Ahmad in March that GPs were indeed consulted, though he didn't specify which organisations or how many were part of the discussion. If media reports are right, GPs in general are not against the new directive on drug price display, but how it was done. While GPs may have a point about the manner in which the directive came to be, they must know that the consumers have a right to know the price of drugs. There are two other reasons why the GPs are unhappy, as they made it clear to the media on May 6. The first reason is that they expected the consultation fees to be announced by the government before implementing the directive on drug prices. We don't pretend to know the reason for this, but the GPs must know that the minister is committed to see the fees reviewed. Media reports say in March the Federation of Private Medical Practitioners' Association of Malaysia had proposed that the consultation fees be revised to from RM50 to RM150. The proposal by the federation may appear like a big increase, but given the high cost of living and inflation today, it might not be an unreasonable request. But still, a thorough study of the proposal is needed. The other reason is that they are against the drug price display rule coming under the Price Control and Anti-Profiteering Act (Act 723), which falls under the Domestic Trade and Cost of Living Ministry. Instead, they want drug price display to be regulated by the Private Healthcare Facilities and Services Act, as other private medical matters are governed. Makes sense. On May 7, Communications Minister Datuk Fahmi Fadzil, who is also the government's spokesman, told reporters that Prime Minister Datuk Seri Anwar Ibrahim had asked Dzulkefli to urgently review the concerns raised by the GPs regarding Act 723. Also to be reviewed will be the consultation charges for GPs. Both are expected to be presented to the cabinet in a week or two. Be that as it may, GP consultation fees need not only an urgent resolution but also a thorough review. It is better to take the time needed for complete review rather than rush through a range that is neither fair to the GPs nor to the patients. A just balance is the way forward. Since 1996 — the year when the consultation fees were last set — the economy has undergone tremendous changes. Cost of living and inflation are up. And a weak ringgit is of no help.
