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Clinics must provide itemised bills & prescription

zstan — Thu, 07 Aug 2025 10:45:26 +0800

KUALA LUMPUR: Private clinics will now be required to provide itemised bills which detail consultations and medicine prices, says Deputy Domestic Trade and Cost of Living Minister Datuk Fuziah Salleh.

It is also now compulsory for doctors to provide prescriptions for every consultation, she added.

“This will allow the patients to make a choice on whether to purchase medicines from the clinics and at other pharmacies,” she said in the Dewan Rakyat yesterday.

These are part of measures introduced by the National Action Council on Cost of Living (Naccol).

“Clinics cannot compel patients to buy medicine directly from them. Patients must be clearly informed that they have the option to obtain their medication elsewhere,” she added.

Fuziah was responding to a question from Bukit Gantang MP Syed Abu Hussin Syed Abdul Fasal, who had asked about the outcomes of Naccol meetings held this year.

She said that Naccol had convened twice so far this year, along with one meeting of its executive committee. Several key decisions were made, particularly in the areas of healthcare cost transparency and household spending.

On Aug 3, the Health Ministry announced that warning letters may be issued to private clinics and pharmacies that fail to comply with the mandatory medicine price display rule, with compound notices to follow from Oct 1. Full enforcement will begin on Jan 1, 2026.

It was reported that during the initial three-month educational phase, which ended on July 31, a total of 842 premises – private medical and dental clinics, hospitals and community pharmacies – were inspected.

The ministry reported that 57% had satisfactorily complied with the price display requirements.

From Aug 1 to Sept 30, the enforcement phase will continue through education, advocacy and inspections before penalties are imposed.

Meanwhile, on food-related initiatives, Fuziah said the government has doubled the allocation for the Rahmah Sales Programme from RM300mil to RM600mil this year to ease the burden on lower-income groups.

In addition, RM25mil has been allocated to extend the Jualan Agro Madani programme, with affordable food sales to be carried out at strategic locations nationwide.

Fuziah also revealed that the government, through Naccol, has begun developing a Cost of Living Indicator and a Minimum Decent Living Expenditure Index.

“This year, advocacy efforts have started to introduce these indicators as a reference for government policy and decision-making,” she said.

She concluded by reaffirming the government’s commitment to monitoring living costs and implementing effective measures to ease the financial pressure on Malaysians.

“These are among the key outcomes from the two Naccol meetings and one Executive Committee session held this year,” she said.

https://www.thestar.com.my/news/nation/2025...-itemised-bills

MMA Launching ‘Black Monday’ Protest To ‘Save’ GPs

zstan — Tue, 03 Dec 2024 22:47:47 +0800

KUALA LUMPUR, Dec 3 — The Malaysian Medical Association (MMA) is launching a “Black Monday” protest to demand urgent reform for private general practitioner (GP) clinics facing threats to their sustainability.

The December 9 protest involves GPs wearing black at their clinic on Monday and making social media posts with various hashtags – including #MalaysiaGPsolidarity, #goBlackforGPs, #saveourGPs, #neglectedGPs, and #stopunfairtreatment – as well as changing their social media profile pictures to black or monochrome.

“General Practitioners (GPs) in Malaysia, with over 12,000 clinics nationwide, face long-standing issues such as outdated fee schedules, absence of regulation for Third Party Administrators (TPAs), and policies that disrupt clinic operations,” according to an internal FAQ by MMA’s Private Practitioners Section (PPS), as sighted by CodeBlue.

“These challenges, persisting for 20 to 30 years, threaten their sustainability, risk clinic shutdowns, and compromise access to quality care, prompting urgent calls for reform.”

MMA’s Black Monday protest follows the Ministry of Health’s (MOH) decision to mandate drug price displays at GP clinics next year.

The Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) recently announced that its GP members would impose a new regulatory compliance charge (RCC) of a minimum RM20, in response to the compulsory medicine price display.

Deputy Health Minister Lukanisman Awang Sauni had no issue with the RCC, simply saying that the fees must be “appropriate”.

The only private health care facility charges regulated by the Private Healthcare Facilities and Services Act 1998 (PHFSA) are doctor fees; all other charges by private hospitals or GP clinics are completely unregulated.

In MMA’s internal FAQ to members on its Black Monday protest, the country’s largest doctors’ group cited four issues: stagnant GP fees, TPAs, the medicine price display mandate, and unlicensed private health care practitioners or facilities.

“Price display policies impact GP clinics by oversimplifying the cost structure of professional health care services. GPs provide not only consultations, but also medications as part of a treatment plan tailored to patients,” said MMA’s Private Practitioners Section.

“The gross profit from medicines is critical for covering operational costs, including doctor and staff salaries, regulatory compliance, consumables, rentals, clinic maintenance, and medical devices.

“While these policies may seem transparent, they are not pragmatic for professional services and can create confusion. Patients may perceive prices as high, without understanding that these costs sustain the clinic’s ability to provide quality care.

“This approach risks undermining public trust and the financial sustainability of GP clinics, ultimately affecting access to professional and reliable health care.”

MMA also pointed out that GPs’ consultation fees – regulated under the PHFSA since 2006 – are still based on the MMA fee schedule from more than three decades ago in 1992. GP fees are fixed at RM10 to RM35.

“With only the Minister having the power to revise these fees, GPs are at the mercy of government action, struggling to sustain their clinics amidst rising costs.”

The doctors’ group further slammed the complete lack of regulation of TPAs that act as middlemen between clinics and employers to manage employee health benefits.

“While GPs provide the services, TPAs charge them fees ranging from RM8 to 16 per cent of the overall transaction. This increases costs, delays payments, and adds administrative burdens for GPs.

“Despite managing health benefits for over three million employees, no ministry oversees their operations, leading to financial strain on clinics and compromising patient care.”

MMA also highlighted the encroachment of unlicensed practices, including certain health care services offered by facilities not registered under the PHFSA, into the role of licensed GPs.

“These activities undermine regulated health care providers, risking patient safety and compromising the quality of care. This creates a double standard, where unregistered facilities operate without oversight, while GPs face strict regulations and micromanagement.

“The government must ensure that all health care providers adhere to the same regulatory standards to protect patients and support ethical primary care practices.”

MMA demanded urgent action on GPs’ unrevised fee schedules, the complete absence of TPA regulation, the drug price display mandate, and unlicensed private health care practitioners or services.

https://codeblue.galencentre.org/2024/12/mm...st-to-save-gps/

GP Clinics to impose Regulatory Compliance Charge

zstan — Wed, 20 Nov 2024 17:51:54 +0800

KUALA LUMPUR, Nov 18 — The Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) has fought back against a Ministry of Health (MOH) mandate for private health care facilities to display drug prices.

FPMPAM today advised its general practitioner (GP) clinic members to institute a regulatory compliance charge (RCC) in their billing as a “relief measure”, pointing out that doctors’ consultation fees under Schedule 7 of the Private Healthcare Facilities & Services Act (PHFSA) 1998 have not been revised for more than two decades.

“This charge will help recover, to some extent, expenses as a result of the many mandatory pressures on the GP and specialist practice where they are required to comply to regulations, without the cost factor and professional and administrative time to the practitioners and clinic staff being taken into account,” FPMPAM president Dr Shanmuganathan TV Ganeson said in a statement.

“These are some expenses loaded on to the aggrieved practitioners:

Compulsory medical indemnity.
PDPA annual fees.
Notification of Diseases administrative cost.
Cost of data provision that has so far been given free by the GPs.
Clinical waste fees.
Expired drugs disposal fees.
“FPMPAM advises members to begin with a minimum charge of RM20 for this Regulatory Compliance Charge, with review to be done from time to time. For MCO (managed care organisation) patients, they are advised to collect directly from the patients. For panel patients, members should bill them accordingly.

“With further new regulations imposed, the RCC charge will be adjusted accordingly.”

FPMPAM has seven state societies with a total of more than 5,000 members nationwide. There are reportedly over 12,000 GP clinics in total across the country.

Health Minister Dzulkefly Ahmad told the Dewan Rakyat last Wednesday that private health care facilities will be required to display medicine prices beginning next year under the Price Control and Anti-Profiteering Act 2011.

In private hospitals, patients are already informed about the prices of their medications – along with their use of equipment, imaging, lab investigations, medical or surgical supplies, procedures, doctor charges, and room and board, among others – in itemised hospital bills after discharge.

But GP clinics do not usually provide patients itemised bills with a breakdown of doctors’ consultation fees, medicine prices, or use of equipment, among others.

FPMPAM’s statement today pointed out that the escalating cost of health care in private hospitals is due to private hospital charges, not fees paid to specialist doctors.

“The same applies to GP practice. The GP consultation and medications are one of the lowest in the region. This basic medical service is available, affordable, and accessible to all who do not wish to use the public facilities,” said Dr Shanmuganathan.

“The policy of the Ministry of Health should be to nurture and support our GP system for the welfare of the patients and not to stifle it with endless unproductive and unnecessary regulations.

“The Report of the Malaysia Productivity Corporation has also clearly indicated that the practice of medicine in Malaysia is already over-regulated. Such unwarranted regulations not only increase cost and decrease accessibility but will endanger the quality of care to the patients.

“This particular price display regulation will be no different.”

FPMPAM noted that the consultation cost of seeing a GP has remained static for the past 20 years, as the MOH failed to update the GP fee schedule and instead “took the erroneous step” to deregulate GP fees. This, according to FPMPAM, left a regulatory vacuum that is being exploited by middlemen.

“Today, commercialised contracts of the middlemen with their various medical cards, exclusion clauses, differential entitled benefits, guaranteed letters and pre-assessment documents have taken over the system,” said FPMPAM.

“This new trend prioritises compliance to administrative guidelines, which directly and indirectly increase cost, at the expense of personalised patient-centric medical care.

“Our private GP system is a time-proven, efficient and cost-effective system and should be used to ease outpatient congestion in all public facilities leaving the government hospitals to focus on secondary and tertiary care.”

FPMPAM claimed that various “quick-fix” measures in the public health care system have failed to reduce long wait times for patients, including increasing operation hours for government OPD (outpatient department) clinics to 10pm; using the emergency department as OPD clinics after office hours; posting more doctors to OPD clinics; sending medicines to patients by post and now e-pharmacy; among others.

“In the past, the private GPs, despite accounting for only 40 per cent of the outpatient health care providers, were able see up to 60 per cent of the out-patient load. Instead of improving this performance, all these quick-fix measures have resulted in the opposite outcome,” said Dr Shanmuganathan.

“GP patient loads have dropped and many GP clinics are closing due to the cost of over-regulation, the micromanagement and the boom of middle-men business in health care.

“The patients are now crowding up the public facilities creating a situation that is worse than before. The waiting times are even longer.”

Citing a 1986 study by the MOH, Dr Shanmuganathan noted that the cost per patient-doctor encounter in a private GP clinic (RM28 per patient) was half the cost in a government clinic (RM56 per patient).

“We are certain a repeat study today will show similar results.”

The Malaysian Medical Association (MMA), another doctors’ group, has similarly warned the government of “serious, unintended consequences” from mandating medicine price displays in private GP clinics.

MMA said this would significantly raise operational costs, pointing out that GP clinics have long relied on “modest” margins from medication sales to manage operational costs and keep services affordable. However, MMA stopped short of advising its members to impose a new regulatory charge.

https://codeblue.galencentre.org/2024/11/fp...isplay-mandate/

MMA disagree to display medicine prices in clinics

zstan — Wed, 13 Nov 2024 18:02:13 +0800

PETALING JAYA: The Malaysian Medical Association (MMA) has poured cold water on the government’s plan to mandate the display of medication prices in private healthcare facilities in 2025, saying it is not practical.

MMA president Dr Kalwinder Singh Khaira said the association supports improving patient access to cost information, but the policy could have serious and unintended consequences for private general practitioners (GPs) who play a critical role in providing primary healthcare services.

“GP clinics provide professional healthcare services, not retail transactions, and displaying a full list of medication prices at the counter would be administratively burdensome and significantly increase operational costs,” he said in a statement.

Kalwinder said these added costs, along with the stagnant GP fee schedule and steadily rising expenses, would strain clinic operations and could even lead to closures, ultimately reducing patients’ access to essential healthcare.

“Furthermore, turning clinics into retail-like spaces risks eroding the quality of the doctor-patient relationship, shifting focus from healthcare to price comparisons,” he said.

Yesterday, Malaysiakini reported that the government will mandate the display of medication prices in private healthcare facilities to enhance price transparency.

Health minister Dzulkefly Ahmad was quoted as saying that the policy will come into effect starting next year as the initiative will be implemented under the Price Control and Anti-Profiteering Act 2011.

He said that with the policy’s implementation, medication charges in insurance claims can be verified to ensure prices do not exceed the displayed rates and prevent arbitrary increases in the cost of medications.

Kalwinder said private clinics have long relied on modest margins from the sale of medications to manage operational costs and keep services affordable.

“This (new) policy affects that balance, making it increasingly difficult for clinics to remain viable.”

He instead urged the government to conduct a thorough review and update of the GP fee schedule as it has remained stagnant for the last two decades.

He also called for the immediate regulation of third-party administrators (TPAs), an issue that has seen inaction since the 1990s and has had an increasing effect on GPs over the years.

“With over 12,000 GP clinics nationwide, it is crucial that policies support these essential community healthcare providers, enabling them to continue serving as the first line of care for millions across the country,” Kalwinder said.

MMA has called for the regulation of TPAs several times, citing issues such as TPAs charging GPs high fees for registration as panel clinics, lacking transparency in their operations, and habitually delaying claim payments.

https://www.freemalaysiatoday.com/category/...nics-hospitals/

Global alert issued over fake Ozempic drugs - WHO

zstan — Tue, 25 Jun 2024 17:26:36 +0800

A global alert about fake versions of Ozempic - which has become popular as a way of losing weight - has been issued by the World Health Organization (WHO).

The drug is sometimes known as a "skinny jab" despite its main purpose being a treatment for type 2 diabetes.

The WHO said the fake medicines could pose a danger to health.

The organisation advised people to source the drug only through reputable sources, such as a doctor, rather than obscure sites online or through social media.

The active ingredient in Ozempic - semaglutide - helps people with type 2 diabetes control the amount of sugar in their blood.

However, the weekly injection also signals to the brain that we're full. So the drug helps people lose weight by reducing the urge to eat.

People without diabetes have been getting hold of the drug as a weight-loss medication.

It has led to shortages for people with type 2 diabetes and created a market for counterfeit drugs.

The WHO said it had been tracking rising reports of dodgy Ozempic all around the world since 2022.

Fake batches have been seized by the authorities in the UK, US and Brazil.

Risk to health

“[We advise] healthcare professionals, regulatory authorities and the public be aware of these falsified batches of medicines,” said Dr Yukiko Nakatani, WHO assistant director general for essential medicines and health products.

The WHO warned some fake injections may not contain semaglutide at all or others may contain other medications, such as insulin, leading to "unpredictable" effects.
"These falsified products could have harmful effects to people’s health," the WHO said.

https://www.bbc.com/news/articles/cn00dkw9479o

Agitated patient stabs another patient

zstan — Wed, 15 Feb 2023 10:53:48 +0800

KUALA LUMPUR - A middle-aged patient in Selangor was seriously injured after being stabbed by an agitated psychiatry patient as they waited in an overcrowded hospital on Tuesday.

The Straits Times understands that the victim, who is a dengue patient, was stabbed three times by the other patient, who was upset over being stranded in the emergency department of Selayang Hospital while waiting for a bed in the wards.

All the wards in the hospital were full at the time of the incident, with dozens waiting for their turns at the emergency department – a reflection that the country’s public healthcare continues to grapple with patient overload and inadequate staff.

The psychiatry patient took a knife from the staff nurse pantry and stabbed the victim once in the back and twice in the abdomen.

The knife ended up being wedged in the victim’s abdomen, who needs to undergo an operation. The hospital and police have not yet commented on the incident.

Tuesday’s incident adds to a growing list of reports of deaths, patient agitation and closure of emergency departments as the country’s hospitals – especially in urban areas – deal with what the health minister called a “tsunami” of non-communicable diseases.

In January, a heart patient died after waiting for over 30 hours for a bed at the Serdang Hospital.KUALA LUMPUR - A middle-aged patient in Selangor was seriously injured after being stabbed by an agitated psychiatry patient as they waited in an overcrowded hospital on Tuesday.

The Straits Times understands that the victim, who is a dengue patient, was stabbed three times by the other patient, who was upset over being stranded in the emergency department of Selayang Hospital while waiting for a bed in the wards.

All the wards in the hospital were full at the time of the incident, with dozens waiting for their turns at the emergency department – a reflection that the country’s public healthcare continues to grapple with patient overload and inadequate staff.

The psychiatry patient took a knife from the staff nurse pantry and stabbed the victim once in the back and twice in the abdomen.

The knife ended up being wedged in the victim’s abdomen, who needs to undergo an operation. The hospital and police have not yet commented on the incident.

Tuesday’s incident adds to a growing list of reports of deaths, patient agitation and closure of emergency departments as the country’s hospitals – especially in urban areas – deal with what the health minister called a “tsunami” of non-communicable diseases.

In January, a heart patient died after waiting for over 30 hours for a bed at the Serdang Hospital.

The same hospital was in the news again earlier in February when a group of patients was filmed confronting staff at the cardiology department after waiting 11 hours for an appointment.

A hospital in Klang also had to close the non-critical zone of its emergency department temporarily earlier in February due to patient overload.

All three hospitals involved in recent incidents, including Tuesday’s, are located in Selangor, which neighbours Kuala Lumpur and is the country’s most populous state.

Selayang Hospital in the densely populated Gombak district.

Malaysia’s public healthcare system is set for a thorough review, as four different administrations in the past four years have not been able to solve long-standing systemic problems.

The country has a highly subsidised public healthcare system, which most of the population is reliant on.

However, its healthcare spending and bed ratio still lag behind more developed countries and World Health Organisation recommendations.

This has led to overcrowded hospitals and also poor employment terms for junior doctors, who eventually quit public service, exacerbating the staffing shortage at many hospitals that serve huge populations.

https://www.straitstimes.com/asia/se-asia/a...another-patient

Government agrees to implement Covid-19 vaccine

zstan — Sun, 19 Sep 2021 14:44:00 +0800

KUALA LUMPUR: The government has agreed to administer a third dose or booster shot of the Covid-19 vaccine after the vaccination rate around the country exceeded 80 per cent of the adult population.

Prime Minister Datuk Seri Ismail Sabri Yaakob in a statement today said priority for the administration of the third dose of the vaccine will be given to high-risk groups such as healthcare frontliners, those who are immunocompromised, senior citizens with comorbidities as well as people residing and working at long-term health care facilities.

"A panel comprising medical and health experts is in the process of formulating the guideline on the implementation of the third dose of the Covid-19 vaccine," he said.

https://www.nst.com.my/news/nation/2021/09/...ne-booster-shot

Italian study shows Covid infections

zstan — Sun, 16 May 2021 13:45:15 +0800

https://www.freemalaysiatoday.com/category/...ing-after-jabs/

ROME: Covid-19 infections in adults of all ages fell by 80% five weeks after a first dose of Pfizer, Moderna or AstraZeneca vaccine, according to Italian research published on Saturday.

The first such study by a European Union country on the real-world impact of its immunisation campaign was carried out by Italy’s National Institute of Health (ISS) and the Ministry of Health on 13.7 million people vaccinated nationwide.

Scientists started studying data from the day Italy’s vaccination campaign began, on Dec 27 2020, until May 3 2021.

The analysis showed that the risk of SARS-CoV-2 infection, hospitalisation, and death decreased progressively after the first two weeks following the initial vaccination.

“As of 35 days after the first dose, there is an 80% reduction in infections, 90% reduction in hospitalisations, and 95% reduction in deaths,” the ISS said, adding that the same pattern was seen in both men and women regardless of age.

“This data confirms the effectiveness of the vaccination campaign and the need to achieve high coverage across the population quickly to end the emergency,” ISS President Silvio Brusaferro said in the statement.

Among the nearly 14 million people included in the Italian study, 95% of those who had taken Pfizer and Moderna had completed the vaccine cycle, while none of those given AstraZeneca had received a second dose.

Up until now, Italy has been following the makers’ recommendations, giving a second dose of Pfizer three weeks after the first, a second dose of Moderna after a four-week gap and a second dose of AstraZeneca after a 12-week gap.

As of Saturday morning, some 8.3 million Italians, or 14% of the population, were completely vaccinated, while around 10 million people had received a first jab.

New Novavax vaccine shows 89% efficacy in UK trial

zstan — Fri, 29 Jan 2021 17:27:40 +0800

A new coronavirus vaccine has been shown to be 89.3% effective in large-scale UK trials.

The Novavax jab is the first to show in trials that it is effective against the new virus variant found in the UK, the BBC's medical editor Fergus Walsh said.

The PM welcomed the "good news" and said the UK's medicines regulator would now assess the vaccine.

The UK has secured 60 million doses of the jab, which will be made in Stockton-on-Tees in north-east England.

The doses are expected to be delivered in the second half of this year, if approved for use by the Medicines and Healthcare Products Regulatory Agency (MHRA), the government said.

The Novavax jab, which is given in two doses, was shown to be 89.3% effective at preventing Covid-19 in participants in its Phase 3 clinical trial in the UK.

The Phase 3 trials - the final stage before a vaccine is looked at by a regulator - enrolled more than 15,000 people aged between 18-84, of whom 27% were older than 65, US firm Novavax said.

In the South African part of the trial, where most of the cases were the South African variant of the virus, the vaccine was 60% effective among those without HIV.

Stan Erck, chief executive of Novavax, said the results from the UK trial were "spectacular" and "as good as we could have hoped", while the efficacy in South Africa was "above people's expectations".

He told the BBC the manufacturing plant in Stockton-on-Tees should be up and running by March or April, with the company hoping to get approval for the vaccine from the MHRA around the same time.

Minister Lucy Frazer told BBC Breakfast the government could not put an exact timeframe on when the Novavax jab might be approved as the regulation process is "out of our control".

But the prisons minister added the NHS would be "ready to distribute [the jab] into people's arms" as soon as supplies become available.

Health Secretary Matt Hancock said the new vaccine would be "another weapon in our arsenal to beat this awful virus", if approved.

Thanking researches and volunteers who took part in the trials, he added: "I'm proud the UK is at the forefront of another medical breakthrough."

Prof Paul Heath, chief investigator of the UK Novavax trial, said the findings of the clinical trials were "enormously exciting findings", particularly because of the jab's efficacy against the UK variant.

Peter Openshaw, professor of experimental medicine at Imperial College London, said the findings that the vaccine gave high levels of protection in the UK part of the trial were "excellent" but that the lower level of protection seen in South Africa was "a concern".

These extremely encouraging trial results suggest another powerful vaccine against coronavirus could soon be within reach.

It works in a slightly different way to the ones that are already available - but does the same job of teaching the body's immune system to recognise and fight the pandemic virus.

What is more, it appears to be effective against emerging and more infectious variants of coronavirus too - something scientists have feared might not be possible because the vaccines were all designed to match the original virus, not these new, mutated versions.

Even the South Africa variant, which has undergone the most worrisome changes, does not seem to be able to fully escape.

Nadhim Zahawi, the UK government minister responsible for the vaccine rollout, said: "Having taken part in Novavax's vaccine trial myself, I am particularly thrilled to see such positive results."

Pfizer and Moderna vaccines rely on technology that has not been used in previous vaccines, but the Novavax jab uses a more traditional method of recreating part of the spike protein of the virus to stimulate the immune system.

Like the Oxford vaccine, the Novavax jab can be stored at regular fridge temperature - which means it can be distributed more easily.

https://www.bbc.com/news/uk-55850352

Malaysia Targets 75,000 Daily Jabs

zstan — Wed, 27 Jan 2021 12:25:42 +0800

KUALA LUMPUR, Jan 27 — The government aims to kick-start the national Covid-19 vaccination programme by immunising 75,000 people a day across 600 vaccination sites nationwide from March.

This is equivalent to 12,500 people per hour in a six-hour day, or five people simultaneously taking jabs at each of the 600 vaccination sites, based on a target of 15 minutes per person.

Science, Technology and Innovation Minister Khairy Jamaluddin said the daily goal of 75,000 jabs to the arm is the government’s first target. The next target, depending on supply, is to administer 150,000 shots a day to take into account the second dose and to complete vaccination of 27 million people, 80 per cent of the population, by March 2022, or the fastest by this December.

He acknowledged potential vaccine supply problems, such as manufacturing delays with Pfizer and AstraZeneca vaccines, as well as regulatory delays with the Chinese and Russian shots.

“The portfolio of vaccines will continue to be rebalanced, continue to be adjusted, so that we can have a decent supply right up to quarter four of this year,” Khairy told CodeBlue in an exclusive interview Monday.

“We want to try to get as much done as possible by quarter two, quarter three, quarter four. We’ve identified about 600 vaccination sites to do this. But we’re also looking at securing other sites, for instance, we’re looking at stadiums, we’re looking at big venues.

“So I think if we consider 75,000 people per day, with the combination of 600 sites — KKM (Ministry of Health) sites, as well as private clinics and private hospitals — plus these mass vaccination sites that I’m trying to coordinate, if things go as planned, we can get it done by December at the quickest,” he said, adding that mass vaccination centres could run 24 hours a day.

He added that the government was also mapping out vaccination sites according to population density and assumptions of demand, estimating how many people can receive shots at each site every day based on the number of people living within a 10km radius from the site, for example.

“Hopefully, in a month or so, or less than that, we’ll have a decent estimate of when we can finish, assuming we have the supply.”

The 600 identified vaccination sites, according to Khairy, comprise Ministry of Health (MOH) hospitals and public health clinics (Klinik Kesihatan), university hospitals, Malaysian Armed Forces hospitals and clinics, private general practitioner (GP) clinics, and private health care facilities. He declined to give a state breakdown for the 600 vaccination sites.

When asked how many private GP clinics have been identified as vaccination sites, since there are 7,000 GP clinics nationwide, Khairy said discussions need to be held at the state level and with private GPs to look at their vaccination capacity and their location.

Khairy said the current ballpark figure was 7,000 vaccination staff, including immunisers, but stressed that it could be much, much higher, more than “easily” 10,000, depending on the number of vaccination sites set up. Besides doctors, the vaccination staff comprise medical assistants, nurses, nurse supervisors, medical students, volunteers, and non-governmental organisations (NGOs).

“We’re going to mobilise not just people in the health service, but also community volunteers, the Red Crescent, the St John Ambulance, we’re going to get as many people as possible to be involved in this. A lot of volunteers.

“Part of it is administering, not anyone can administer, but we want to ensure that all the support services — the work from registration, to surveilling 15 minutes after you receive [a jab] to make sure there’s no adverse reaction — we want to make sure there’s enough people there.”

He said the government would also look at roping in community pharmacists to administer shots, acknowledging that MOH does not have enough staff to run the Covid-19 vaccination programme. MOH health workers have already begun training for coronavirus immunisation.

“By our calculations, for the first phase which is frontliners, we have enough MOH staff to roll out the first phase, then we’ll start training the rest as we go along.”

The United Kingdom aims to recruit and train volunteers, including non-clinicians, to administer coronavirus vaccines under clinical supervision. A registered health care professional is needed to carry out the clinical assessment and consent.
“The rate of vaccination at private GP clinics, we’re projecting, is not going to be very high,” Khairy said.

“This is more for convenience. If an elderly person is staying in a particular place where it might be far to go to the hospital or the sites, they can go to the local GPs. We’ll have a list on the website, we’ll have it listed in MySejahtera as well, where you might find an appointment.”

He added that the government would pay private GPs for their Covid-19 vaccination services; their patients will receive the shots for free.

“It is an opportunity cost for the GPs, so we’re prepared to pay for it,” Khairy said, adding that the payment rate for GPs will be released later.

The military, which runs its own parallel health service to MOH, will also be recruited to the national Covid-19 vaccination programme.

Khairy said the Malaysian Armed Forces can set up field vaccination centres in the interiors where people may find it difficult to go out to get immunised. The military will also vaccinate civilians in the surrounding areas of army hospitals, such as in Setiawangsa.

“We’re also using the military for logistics planning and security, especially at the sites where we’re storing the vaccines,” he said, adding that 55 “highly secure” storage sites with ultra-low temperature freezers for Pfizer vaccines have been identified.

Khairy declined to reveal the location of these 55 storage sites.

The government, he said, is building a website for people to register for shots. The website will also have an online dashboard to show the country’s daily Covid-19 vaccination rates.

sos

53-page FDA report reinforces safety and effective

zstan — Wed, 09 Dec 2020 14:36:00 +0800

The U.S. Food and Drug Administration on Tuesday released a 53-page report summarizing data from Pfizer and BioNTech's COVID-19 candidate vaccine trial. The data supports earlier findings that the vaccine is safe and will prevent 95% of people from becoming sick with COVID-19.

The companies are asking the FDA for authorization to use the vaccine in people ages 16 and up. They have also begun testing the vaccine in ages 12-15, but have not yet accumulated enough data to request authorization in that age group.

The FDA panel that must review the vaccine before authorization meets all day Thursday, with authorization expected as soon as that evening. Another candidate vaccine, made by Moderna, will be reviewed next week.

Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee, said he recently received a briefing on the Pfizer/BioNTech data, though he would not say who presented it or who else received it.

Trading COVID-19 vaccines. Regular deliveries. Tracking doses:What we know about Operation Warp Speed distribution process.

"The group I was with who heard the data arrived interested and left the presentation enthusiastic," Schaffner said. "The extraordinary thing is that there were no major areas of concern."

Others also seemed impressed by the results.

"FDA did not note any surprise finding," said Dr. John Grabenstein, a former Merck executive and former director of US Department of Defense military immunization program. The efficacy and product quality look good, Grabenstein said in an email, and there were few severe cases of COVID-19 in the vaccine group.

The report provides more detail on how certain groups of people fared with the vaccine, called BNT162b2, including people over 65, those with pre-existing medical conditions, like diabetes, and those who are Black and/or Hispanic – all of whom appeared to be as well protected as the general population.

Pfizer's COVID-19 vaccine is being shipped in specially designed, insulated containers that hold between 195 and 975 five-dose vials and are about the size of a carry-on suitcase. The vials are stored in flat, pizza box-sized compartments, each of which holds 195 vials. A fully-loaded thermal container, which is reusable, contains five of these and weighs about 70 pounds.
Roughly one-third of participants met the definition of obesity, lower than the general population of the United States, but still high. The average age of participants was 51. They appeared to be as well or better protected than everyone else, countering the concern that the vaccine might not work as well in people who are older or who have conditions that might make them more vulnerable to serious disease.

The report also noted that the first vaccine dose seemed to be 52% protective, although because everyone received a second dose three weeks after the first, there’s no evidence of protection lasting longer than a few weeks.

With other vaccines, a second or booster shot extends the protection they provide.

“We don’t want to just get you through the night,” Schaffner said, adding that he’d rather be pleasantly surprised if the vaccines are shown to work after just one dose than unpleasantly surprised by people getting sick who stopped at their first shot.

Many trial participants endured side effects for a day or two after getting their shots, particularly the second one. The most commonly reported side effect among vaccine recipients under age 55 was a sore arm, followed by fatigue (60% after the second shot); headache (52% after the second shot); other muscle aches (37%); and chills (35%). About 28% took pain medication after the first shot and 45% after the second shot.

There were "no surprises" in terms of safety, Grabenstein noted. Four people in the vaccinated group developed Bell's palsy – a temporary weakness of muscles in the face that causes one side to droop or stiffen – but that may or may not have been caused by the vaccine, and the FDA referred to the cases as "non-serious."

Other “serious adverse events” were reported in both groups, including two deaths among those who received the active vaccine and four among placebo recipients, but they were unlikely to be related to the vaccine, the report concluded.

Overall, the FDA report concluded the data "meets the agency’s expectations … The frequency of non-fatal serious adverse events was low (less than .5%), without meaningful imbalances between study arms.”

The study also noted that Pfizer/BioNTech will offer BNT162b2 to anyone who received the placebo if they request it, and to all placebo recipients six months after their second dose.

Pfizer/BioNTech will continue to study these trial participants and will also undertake several new studies to follow people who receive the vaccine after it is authorized, according to the report.

While the vaccine has been shown to be safe among the 22,000 people who received it, rare health complications are likely to arise as it is used in hundreds of thousands and then millions of people.

Despite the thoroughness of the report, there are still unanswered questions.

Among the big ones:

How long will the vaccine last?
FDA will consider "authorizing" this vaccine, but will not issue a full approval because there is no data on how long the vaccine will be protective.

Officials decided that in the midst of a pandemic, it was good enough to ensure that the vaccine was safe and at least transiently effective, rather than withholding it for two years to await the typical long-term results required for a full approval.

Vaccine companies intend to follow trial participants for two years and submit a full application when they have that data.

The FDA noted in the report that Pfizer/BioNTech must periodically review the safety of their vaccine, including breakdowns by age, special populations, such as pregnant women, and serious adverse events.

Does the vaccine prevent infection or just symptoms?
Right now, all we know is that the Pfizer/BioNTech and Moderna candidate vaccines prevent COVID-19 symptoms and serious disease. It's not clear whether someone could catch the virus that causes COVID-19 and pass it on to someone else, even without becoming ill.

The studies designed to test the candidate vaccines only examined symptomatic infections, not whether vaccinated people could still be contagious.

This means that people who are vaccinated can be pretty sure that they won’t develop COVID-19 themselves, but they could still pass it on to others without knowing they are infected.

Pfizer and BioNTech released early study results indicating that their vaccine prevented more than 90% of infections with the virus that causes COVID-19.
Regulatory officials thought it was more important in the middle of a deadly pandemic to prevent sickness and didn't want to slow down trials by adding extra requirements. Future studies will explore this.

“That’s one of the reasons you’ll still have to keep wearing your masks and social distancing,” said Schaffner, who was not involved in developing any of the COVID-19 candidate vaccines, but has followed the process closely. Proving that vaccines prevent transmission, he said “would have taken much longer, much more money and might have (required a) much larger trial.”

He defended the decision to focus on preventing disease rather than worrying about transmission.

“We would like to keep people out of the hospital, out of the intensive care unit and not subject to the risk of dying,” he said. “I’ll take that.”

Early indications from a study released Tuesday in The Lancet suggest that the AstraZeneca/Oxford University candidate vaccine at least partially prevents a vaccinated person from transmitting the disease.

Could the vaccine make subsequent infections worse?
There has been concern that getting vaccinated against COVID-19 might cause a subsequent COVID-19 infection, as some dengue vaccines have been shown to do for that disease.

The FDA concluded that use of the vaccine has not been widespread enough to know for certain, but that “available data do not indicate a risk of vaccine-enhanced disease, and conversely suggest effectiveness against severe disease within the available follow-up period.”

The risk does remain over time as immunity against the disease wanes, the FDA said, and “needs to be evaluated further in ongoing clinical trials.”

What about children and pregnant women?
The data only included children ages 16 and up, though the study has since been extended to age 12, and will include younger children as soon as the company decides what dose it wants to test in this group.

Pregnant and nursing women were not included in the study, so there is no data to suggest whether they should avoid vaccination. In a meeting last week of a CDC group that determines how vaccines should be allocated, several expert members said they expected the vaccine would be safe for mothers who are nursing because the virus itself does not seem to pass through the mother’s milk.

Overall, Schaffner said, the process of developing and testing the candidate vaccine will look simple in comparison to the challenges of delivering it to a country of 328 million and beyond.

It will be, he said, "a much larger, longer, intensive, expensive effort and will require great commitment, great persistence, great communication.”

Other new studies Pfizer/BioNTech plans to conduct include: a survey of 20,000 U.S. health care workers enrolled in the COVID-19 HERO registry, among others; and a 30-month-long study using data from the Department of Defense Health System electronic health records to examine vaccine results among covered U.S. military and their families. The companies also will look for any adverse events associated with the vaccine using the Veterans Health Administration electronic medical record database.

https://www.usatoday.com/story/news/2020/12...ive/3860002001/

Has Sweden’s coronavirus strategy failed?

zstan — Tue, 01 Dec 2020 13:58:33 +0800

Sos

Even Sweden appears to be abandoning the Swedish model. On Monday, the country’s authorities banned gatherings of more than eight people as they grappled with the second coronavirus wave surging through much of Europe. The new restrictions followed other protocols coming into effect this week, including protective measures around nursing homes and bans on alcohol sales at restaurants and bars after 10 p.m.

Sweden’s economy, heavily dependent on global value chains, has suffered like those of other European countries, no matter the absence of restrictions imposed by the government during the pandemic. “Not only did these lack of measures likely result in more infections and deaths, but it didn’t even help the economy: Sweden has fared worse economically than other Nordic countries throughout the pandemic,” wrote Sweden-based researchers Kelly Bjorklund and Andrew Ewing. “The Swedish way has yielded little but death and misery.”

Sukuk Prihatin

zstan — Mon, 17 Aug 2020 19:54:22 +0800

KUALA LUMPUR, Aug 20 ― The Malaysian government on Monday launched the Sukuk Prihatin with the target of raising RM500 million to aid the country’s economic recovery amid the Covid-19 pandemic, by opening up an opportunity to Malaysian individuals and companies to invest in the Shariah-compliant investment instrument or Islamic bond through the lending of their money to the government for two years.

Beyond helping with the government’s efforts in rebuilding the economy after the Covid-19 pandemic, Malaysians who choose to put money into Sukuk Prihatin will be able to get back the principal or initial sum at the end of the two years, along with profits at a fixed rate every three months during the two-year period.

Below is a quick highlight and summary of some of the key points in the government’s 61-page knowledge pack on Sukuk Prihatin:

1. What is it?

The government is the issuer of Sukuk Prihatin, which means the government has a direct obligation to the investor for the principal and the profit payments. The Sukuk Prihatin is a one-off issuance by the government.

It is poised as a gateway for Malaysians to unite and join in Malaysia’s economic recovery measures, with the knowledge pack stating: “Themed ‘Forwarding The Nation’s Future Together’ and #KitaUntukKita, the Sukuk Prihatin will carry nationalistic and patriotic elements to rally fellow Malaysians to participate in rebuilding the economy and the nation while enduring Covid-19 crisis.”

2. Who is it for?

To be eligible to invest in Sukuk Prihatin, you have to either be a Malaysian aged at least 18; or a company incorporated in Malaysia; or a cooperative, foundation, sole proprietor, partnership, association or other incorporated bodies operating in Malaysia. A registered trustee can act on behalf of any of the previous three categories, but will not be able to enjoy tax exemptions related to the Sukuk Prihatin.

With Sukuk Prihatin having a short two-year tenure, it is stated to be suitable for investors who “wish to diversify their investment portfolio and are comfortable taking a short-term risk with a minimum return on investments”.

3. How do you apply?

This is Malaysia’s first-ever digital sukuk, which means investors can apply during the subscription period from August 18 to September 17 to invest in Sukuk Prihatin via internet or mobile banking through the JomPAY and DuitNow platforms, depending on the banks involved.

Since Sukuk Prihatin is being offered fully digitally, applications cannot be made over the counter or through the ATM with such applications to be rejected and refunded.

There are 27 participating banks for both corporate and retail investors, with some either offering JomPAY or DuitNow e-channels or both.

Specifically for retail investors, they can subscribe to the sukuk via the internet or mobile banking through their accounts at: Affin Bank, Agrobank, Alliance Bank, Al-Rajhi Bank, AmBank, Bank Islam, Bank Muamalat, CIMB, Hong Leong Bank, Maybank, MBSB, Public Bank, RHB, Bank Rakyat, Bank Simpanan Nasional, Bank of China (Malaysia) Berhad, Citibank, HSBC, ICBC Bank, OCBC Bank, Standard Chartered Bank, or United Overseas Bank (Malaysia) Berhad.

But applications to subscribe to Sukuk Prihatin will be reviewed to see if all requirements have been met, with applicants to be informed 14 days after the offering period on whether they were successful and with refunds of the money to be done within five days if an applicant is unsuccessful.

4. How much is the minimum and maximum investment amount?

You can apply more than once to invest in Sukuk Prihatin which is on a first-come-first-served basis.

But the condition is that you have to use the same bank account to apply, and with each application to be at least a minimum of RM500 and in multiples of RM100. There is no maximum limit for how much can be invested.

What this means is if you were to apply to invest RM610 in Sukuk Prihatin, RM10 will be refunded to your account within five business days as only multiples of RM100 are allowed.

If you then decide to make another application to invest RM400 or any other amount below RM500, that would not be possible and you will need to top it up to at least RM500 when applying to avoid your application being rejected.

Only applications made from the bank account for the first application will be accepted, while subsequent applications from other bank accounts from the same or different bank will be rejected and refunded.

Make sure you will not need the money that you invested in Sukuk Prihatin for two years, as investors are not allowed to redeem or take the money out before the sukuk’s maturity date and with all such investments required to be held until the end of the two-year period.

You can’t sell off your holding in Sukuk Prihatin or transfer or assign it, which means you have to hold the sukuk which you bought until its maturity date of September 22, 2022.

(With lots sizes of RM100 and a minimum RM500 amount, Sukuk Prihatin is different from the traditional sukuk where institutional investors would have to invest in standard lot sizes of RM5 million.)

5. How much would you get in return for your investment?

At a fixed profit rate of 2 per cent per annum, putting in RM1,000 into Sukuk Prihatin will translate into a RM20 profit per year, which will then be paid to you in four tranches of RM5 for each quarter in a year.

At the same profit rate, putting in RM10,000 would mean a total profit of RM200 per year, which will then be divided into four to be paid to you in sums of RM50 for each quarter or every three months.

If the Sukuk Prihatin’s issue date is September 22, 2020, the first time you will receive your profit payment will be on December 22, 2020.

The government will continue to pay the profit payments to you every quarter until the end of the two-year period for Sukuk Prihatin (September 22, 2022), which will be also when you get your initial investment sum or principal back, unless you choose to donate either all or some of the principal to the government for spending related to Covid-19.

For example, if you decide to waive RM3,000 of your RM10,000 initial investment sum at the end of the two years, you will get RM7,000 back while the RM3,000 will go to a government-approved trust account.

The profit is tax-exempted but you will have to keep the monthly e-statement for Sukuk Prihatin for such purposes, while the waived or contributed amount will be tax-deductible.

You can choose whether to waive your principal when making the application, and can decide in the final quarter whether to change your decision or change the amount you wish to waive or contribute.

6. What will the funds be used for

According to the knowledge pack, the proceeds from Sukuk Prihatin will go to the Kumpulan Wang Covid-19 to fund measures announced in the government’s economic stimulus packages and recovery plan to address the Covid-19 crisis.

Examples of such measures include medical spending related to Covid-19, financing or grants for micro and small and medium enterprises especially women entrepreneurs, grants for research for infectious diseases, and improving connectivity to rural schools which will act as hubs to connect nearby villages, the government said.\

https://www.malaymail.com/news/malaysia/202...-yourse/1895447

__________________________________________________________________________________________________________________________

KUALA LUMPUR, Aug 17 — The Ministry of Finance (MoF) is expected to announce the issuance of Sukuk Prihatin, Malaysia’s first digital sukuk, amounting to RM500 million under the National Economic Recovery Plan (Penjana) in a ceremony tomorrow.

The MoF, in a statement today, said the opening ceremony of Sukuk Prihatin will be officiated by Prime Minister Tan Sri Muhyiddin Yassin and Finance Minister Tengku Datuk Seri Zafrul Tengku Abdul Aziz.

The ceremony will be graced by the Yang di-Pertuan Agong Al-Sultan Abdullah Ri’ayatuddin Al-Mustafa Billah Shah.

The ministry said the issuance of shariah-compliant Sukuk resulted from requests from various parties in their quest to assist in the country’s recovery efforts.

The Sukuk Prihatin issuance will be channelled to a number of initiatives that have been identified, including increasing connectivity for rural schools, accommodating research grants for infectious diseases, and financing micro-small and medium enterprises (MSMEs), especially women entrepreneurs, the statement said. — Bernama

https://www.malaymail.com/news/money/2020/0...obox=1597664590

Where to subscribe:

1) Maybank?
2) Hong Leong
3) BSN

Subscription period: 18th August to 17th September 2020.

Face Mask Ceiling Price Increased

zstan — Fri, 20 Mar 2020 11:24:53 +0800

Expect masks to come in very soon.

https://www.facebook.com/MalaysianPharmaceu...903026123114201?

Mandatory Prescriptions Rule Won’t Trigger

zstan — Wed, 22 Jan 2020 11:01:21 +0800

https://codeblue.galencentre.org/2020/01/21...ing-separation/

PETALING JAYA, Jan 21 — A proposed legal amendment to criminalise physicians for not issuing drug prescriptions requested by patients will not lead to dispensing separation, a health official said today.

Dispensing separation means separating the prescribing and dispensing of medicines to doctors and pharmacists respectively, a common practice in other countries that is not done in Malaysia as many doctors still dispense the drugs they prescribe.

“If you look at the amendment, you cannot find the word ‘dispensing separation'”, Dr Ramli Zainal, senior director of the Ministry of Health’s (MOH) Pharmaceutical Services Programme said, referring to the Poisons (Amendment) 2019 Bill that was tabled for first reading in the Dewan Rakyat last year.

Speaking at a media engagement session at the National Pharmaceutical Regulatory Agency’s headquarters here, Dr Ramli said it was “a hypothetical question” to put to the ministry.

“It’s very difficult to answer such a question,” he added, but said dispensing separation was not one of the main objectives for amending the Poisons Act 1952.

Dr Ramli also spoke of a previous town hall session that Health Minister Dzulkefly Ahmad attended, where he purportedly told the Malaysian Medical Association that the issue of dispensing separation will “resolve by itself” with a health care financing system in place.

“If we look at other countries that practice national health financing…they don’t talk about dispensing separation because there will come a time when doctors will just prescribe (medicines) and dispensing is done by pharmacies or clinics.”

MOH came under fire from several physician groups and lawmakers last year for proposed amendments to the Poisons Act that would make it mandatory for doctors, dentists, and veterinarians to provide prescriptions upon request from patients. Failure to do so would see them guilty of an offence that is punishable by a maximum RM50,000 fine, up to five years’ imprisonment, or both.

The Medical Practitioners Coalition Association of Malaysia previously alleged that the amendment Bill was a “backdoor entry” for dispensing separation, making reference to an attempt to raise a Bill on dispensing separation by the previous Barisan Nasional administration in 2015, but which was halted because of opposition from doctors’ groups.

Deputy Health Minister Dr Lee Boon Chye last November tabled an amendment to the Poisons Act 1952 in the Dewan Rakyat, but after intense public outcry, the second reading for the amendment Bill was pushed to the next Parliament meeting in March.

Consultations with stakeholders to go over provisions in the Bill are slated on February 13, Dr Ramli said today.

On whether MOH will delete sections in the amendment Bill that make it a criminal offence for doctors, dentists, and vets to decline issuing prescriptions upon request, Dr Ramli said to wait for the outcome of the February 13 meeting.

“We’ll have another engagement, and based on the outcome of that engagement, we will make a decision,” he said.

He also said it was incorrect to say that MOH enforcement officers will have excessive powers, referring to a section of the amendment Bill that would give its officers the same powers as the police to search private clinics, hospitals, or other premises, and to seize documents if an offence was suspected. Some doctors had said this would supersede confidentiality provisions in other laws.

“You must remember that we are enforcing the Poisons Act (cutting across) a lot of other sectors, not just involving clinics and doctors; we also have the other end of society that smuggles in illegal products. So we need to have a law that caters for every offence.”

On a provision in the Bill on electronic prescriptions, where they are to be signed with a digital signature and sent to a registered pharmacist as an electronic message, Dr Ramli said it would be beyond the purview of the Poisons Act to create a system to track all these prescriptions.

However, he said MOH will be able to authenticate online prescriptions, especially if they’re coming from “bogus doctors”, so long as the system complies with a Digital Act. He added that the idea was mooted in order to keep with the times.

Vietnam replace written prescriptions

zstan — Sun, 29 Dec 2019 09:54:57 +0800

While Malaysia still can't get paper prescriptions.Inb4 lowyat.vn

Written medical records could be on their way out, as pilot software will allow patients to use codes to access their e-prescriptions on a national online prescription system.

Speaking at a workshop last week, Associate Professor Luong Ngoc Khue, Director of Medical Services Administration under the health ministry, said the software would be applied across the country at all public and private healthcare facilities after a recently launched pilot in Ha Tinh and Hung Yen provinces.

According to Khue, among nearly 50,000 medical facilities nationwide, 95 per cent have prescription management software. However, the data is not synchronised, making it difficult to share data among facilities.

Up to 70 per cent of pharmacies have medicine management software but still sell medicine without prescriptions.

Private medical facilities, prescriptions are written so it is difficult to track who prescribed the medicine and to ensure the prescribed medicine is sold to patients.

Vietnam Company Formation
“Since the software is applied nationwide, written medical records will be replaced with technology,” he said.

All prescriptions sent from healthcare facilities nationwide would be saved on the software and shared with patients and medicine suppliers.

The e-prescriptions would be connected with e-medical records.

Through the system, only prescribed medicines could be sold to avoid the abuse of antibiotics and controlled medicine.

“Patients can track the names of doctors who prescribed the medicine to ask for repeat prescriptions and give feedback. Data will be saved on the system to identify prescription violations,” he said.

Patients would be also warned of outdated and prohibited medicine.

Nguyen Ha, an office worker in Hanoi’s Hoan Kiem District, said “The national e-prescription is such a good idea to manage prescription in the era of 4.0. My parents and children have to go to hospitals for health check-ups regularly. It’s more convenient without having to bring written prescriptions. I only need to tell the pharmacist the code to buy medicine.”

The system is being piloted in Ha Tinh and Hung Yen and has been assessed as operating smoothly so far. The pilot is set to end in a year.

All prescriptions have been sent to the software and shared with the health ministry, local health departments and healthcare facilities. Pharmacies have received the prescriptions and sold medicine following the prescriptions.

With only one code for each prescription, patients can buy medicine anywhere in Vietnam.

In 2018, the health ministry launched a software to connect medicine supplying facilities. This year the ministry has made a move with online prescriptions in order to push towards electronic healthcare.

https://www.asiaone.com/digital/e-prescript...ersions-vietnam

From a patient’s perspective

zstan — Tue, 24 Dec 2019 09:57:51 +0800

THIS issue of whether we should separate the prescription and dispensing of medicine between doctors and pharmacists cropped up after the number of pharmacists in the country started to increase some 10 to 20 years ago. If I remember correctly, as expected, the pharmacists were the ones who first raised this issue, as the practice since the early years right up to now has been that doctors prescribe and dispense medicines.

In recent days, as the debate on imposing this separation of duties arose again, the Malaysian Pharmaceutical Society and the Federation of Private Medical Practitioners Associations have each offered their views – the former obviously is for separation while the latter wants to keep the status quo.

Who should we, the patients, listen to? Who is right? Should we care about what is happening in other countries?

I have not read much the views of patients themselves. So I thought I will share mine. I have no interests on either side except as a patient. I am 60 years old and I am not a doctor or pharmacist, and neither do I have family members who are doctors or pharmacists.

Why do we need to change something that has worked so well for us these past decades? Why do we need to change the status quo where private doctors prescribe and also dispense medicine? Have many patients complained? Yes, they have complained about the terribly high costs of treatment in private hospitals but few, as far as I am aware, have said the same of private medical practitioners who have set up their own clinics all over the country, from big cities to small towns.

There may be more complaints soon with the deregulation of the fee structure for such doctors recently by the Health Ministry. But even then, I believe the majority of, or even all, patients will agree with keeping the status quo when it comes to medicines. It will be really inconvenient for a patient, especially one who is very ill, to have to go looking for a pharmacy to get medicines after seeing a doctor.

Cheaper to get medicines from the pharmacies? Who said so? I believe it is cheaper in the current system, as the doctors have already earned some income from the consultation fees and will probably charge only a little bit more for the medicines to recoup costs. If there is separation, what do you think will happen when pharmacies know that you have no choice but to go to them to get the medicines, even if they say they can sell at lower prices because they get their supplies in bulk?

And how do you think doctors will charge for consultation if there is separation? You can probably guess they will charge more, even with the fee deregulation, to continue earning what they used to. So, more inconvenience and, I am sure, higher costs as well if there is separation between the prescribing and dispensing of medicines.

Please listen to patients before making changes to the current system. Please don’t say that pharmacists also have to earn a living. Nobody asked them to become pharmacists. Pharmacies, I can tell, are already making huge profits with the current system. How do I know? Just look at the increasing number of pharmacies sprouting in your township!

We need doctors more than pharmacists. We have been managing well in all the decades since independence. So why the need to change? And, no, I will not be rewarded by the Federation of Private Medical Practitioners’ Associations for this letter.

A 60-YEAR-OLD PATIENT

Petaling Jaya

https://www.thestar.com.my/opinion/letters/...nts-perspective

Pay cut for future doctors,pharmacist, dentist

zstan — Tue, 24 Dec 2019 08:59:02 +0800

TLDR: RM750 pay cut for new intakes of doctors, pharmacist, dentist in ministry of health.

Discuss the impact of this (dua puluh markah)

Today we have been informed regarding a new circular that once again looks at reducing one of the incentives given to the hardworking and ever sacrificing healthcare professionals, which are part of the 33 critical professions involved. The circular dated 20th December 2019 signed by the new KPPA states that after careful review, the JPA with the approval of the Jawatankuasa Khas Kabinet Pembaharuan Perkhidmatan Awam JKK-PPA, chaired by the Most Honourable Prime Minister, has decided to remove the Critical Allowance for all newly hired staff. All existing staff receiving the critical allowance will continue to enjoy this incentive till retirement or leaving of service.

This would lead to a reduction of RM 750 from the pay of our newly recruited junior doctors, already reeling from the lack of job prospects within the Ministry of Health and the Malaysian Civil Service followed by the demeaning lack of promotion upon completion of Housemanship. The latter issue was supposedly resolved as announced by YBMK and SCHOMOS has the assurance from YB Minister of Finance that the Ministry would look favourably upon any request made by the MOH but till today there is no formal announcement of the U43 promotions for all contract medical officers.

A little bit of history….
The critical allowance was given by the government to incentivize the positions within the civil service that was deemed to be critical to the country as well as being a position that was difficult to fill or being of low demand. This is as explained in the circular and the attached FAQ below. The 4 criteria are as outlined below
1. The profession selected should be within a field or area of interest as determined by the government to be of critical importance to the growth and development of the nation.
2. The profession should be one in which there is great competition for candidates with the government needing to incentivize the positions to attract the best talents
3. The profession should be one with specialized skills and expertise
4. The profession exposes the candidate to a variety of dangers and risks

Looking at the 4 criteria above, it would seem that the healthcare sector should not be affected. The healthcare sector has been earmarked as one of the pillars of growth and an area to develop and drive the economy. There is a clear need for specialized skills and expertise within all levels of healthcare, from the nurses to the HOs, MOs and specialists. All healthcare staff are specially trained to deal with the care of the Rakyat to ensure their continued wellbeing. The dangers and risks that all healthcare professionals and support staff undertake is immense. Daily we deal with a variety of infectious diseases like TB, influenzas and blood borne infections, with sharp and dangerous instruments, with a threat to our mental and physical health by way of the immense workload and stress imposed on us by the need to provide the services demanded upon by the patients, our clients.

I have said it once and will state again, all healthcare professionals has worked through illnesses like high grade fevers, cough and flus which would have seen most office staff scurrying for the nearest doctor for a medical day off, which we do not have the luxury to take due to the tight scheduling problems we all face. The current “oversupply” is again not one of too many doctors or nurses, but one of the lack of available positions to properly get the job done without taking a toll on the physical and mental well being of the healthcare professional involved. This Christmas and holiday season once again will see many a Doctor or Nurse who wished to celebrate with their loved ones, instead sacrifice those precious moments to answer a higher call, one to serve and save the lives of those patients under our care.

The one area that can be disputed is criteria number 2. The fact that there is a mismatch in the number of available newly trained healthcare professionals to the positions the Civil Service has on offer. This I do agree would paint a picture of a “glut” and somewhat justify the removal of the critical allowance for newly employed healthcare staff. However, given that we still meet the other 3 criteria, wouldn’t an employer seem more compassionate to continue with this critical allowance? Every elected representative we have met has stated that they are sympathetic to the calls and laments of the healthcare staff, but being sympathetic is not enough in this case. Again, a serious injustice has occurred, affecting the junior staff, and with the simple aim of reducing the wage burden on the country. While I will always support prudence, I will never agree that the prudence would come at the expense of any organization’s greatest asset, namely their staff / human resource.

I do have to be thankful that the JKKPPA had the wisdom not to pull back the entirety of the incentive from the entire government service, which was what has been “implied” during our various meetings with JPA in the past few years. The spirit in which the incentive was started for the healthcare professionals was in reward for the sacrifices and risks that we take daily in the discharge of our duties. I call upon the Ministry of Health to appeal to the JPA again to reconsider this revocation of this incentive for our junior colleagues in medicine, nursing, dentistry and pharmacy. The healthcare profession is still one that is growing and developing. With all the reasons outlined above, I do feel that the “critical” nature of our work cannot be disputed.

To the junior healthcare professionals, the rice bowl may be broken but we in the associations are working hard to practice the art of kintsukuroi to repair it and hopefully ensure a better future for all healthcare professionals in the future. Do stand with us to lend us your voice so that we can go further to protect your futures.

Dr Kevin Ng
SCHOMOS Chairman 2019

https://www.facebook.com/nivekng19/posts/10163192828820599

Urgent need to regulate medicine prices

zstan — Thu, 19 Dec 2019 11:31:43 +0800

Medicines are not a commodity. Healthcare is a basic consumer right, and a major component of healthcare is the administration of medicines. Medicines cure people and should never be treated as just another commodity, where pricing and accessibility would be determined by market forces. The government has a critical role to play to ensure that all consumers, especially the low and middle income have access to affordable medicines.

A market review on the pharmaceutical sector was undertaken by the Malaysia Competition Commission. According to the report, “Malaysian drug prices are high by international standards”.

It appears that the pharmaceutical companies in Malaysia are making exorbitant profits by international standards. In another study, it was found that “Malaysia has average higher retail prescription prices compared to Australia due to the lack of pharmaceutical regulation”.

Further according to the Pharmaceutical Services Programme on Medicines Prices Monitoring Malaysia (2017), wholesale medicine prices in Malaysia are eight times greater than the International Reference Price (IRP).

And according to the Penang Institute, the median mark-up for originator’ and lowest-priced generics in private hospitals was 51% and 167% respectively.

Based on the above unjust situation referring to the excess medicine prices Malaysian consumers need to pay for medicines, the health ministry is working on a mechanism of medicines pricing that would put in place a regulatory framework to ensure access of medicines at fair prices for the rakyat. The essence of the mechanism is that prices along the supply chain must be transparent and there would be a ceiling price at the level of wholesale and consumer prices.

According to the World Health Organization (WHO), an “affordable and fair price” is one that can be funded by patients and health budgets and simultaneously sustains research and development, production and distribution within a country. Further WHO proposes that all nations, high income and low income, in their efforts towards universal health coverage, should have policy measures to control and regulate the price of medicines.

Without price control in Malaysia, in the so-called “free market” currently, the medicine prices in Malaysia are “high by international standards”.

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Urgent need to regulate medicine prices
Paul Selva Raj -December 18, 2019 8:49 PM
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Medicines are not a commodity. Healthcare is a basic consumer right, and a major component of healthcare is the administration of medicines. Medicines cure people and should never be treated as just another commodity, where pricing and accessibility would be determined by market forces. The government has a critical role to play to ensure that all consumers, especially the low and middle income have access to affordable medicines.

A market review on the pharmaceutical sector was undertaken by the Malaysia Competition Commission. According to the report, “Malaysian drug prices are high by international standards”.

It appears that the pharmaceutical companies in Malaysia are making exorbitant profits by international standards. In another study, it was found that “Malaysia has average higher retail prescription prices compared to Australia due to the lack of pharmaceutical regulation”.

Further according to the Pharmaceutical Services Programme on Medicines Prices Monitoring Malaysia (2017), wholesale medicine prices in Malaysia are eight times greater than the International Reference Price (IRP).

And according to the Penang Institute, the median mark-up for originator’ and lowest-priced generics in private hospitals was 51% and 167% respectively.

Based on the above unjust situation referring to the excess medicine prices Malaysian consumers need to pay for medicines, the health ministry is working on a mechanism of medicines pricing that would put in place a regulatory framework to ensure access of medicines at fair prices for the rakyat. The essence of the mechanism is that prices along the supply chain must be transparent and there would be a ceiling price at the level of wholesale and consumer prices.

According to the World Health Organization (WHO), an “affordable and fair price” is one that can be funded by patients and health budgets and simultaneously sustains research and development, production and distribution within a country. Further WHO proposes that all nations, high income and low income, in their efforts towards universal health coverage, should have policy measures to control and regulate the price of medicines.

Without price control in Malaysia, in the so-called “free market” currently, the medicine prices in Malaysia are “high by international standards”.

The time to regulate medicine prices is way overdue.

Yet the response by big Pharma against a fair and just price for medicines is extremely negative. As expected with the high prices being charged, they would want to minimise any form of regulation that would impact their profits. While making profits is obviously justifiable by any private company, excessive profits on medicines would have a serious negative impact on patients and consumer well-being. Excuses such as medical tourism would be affected if medicine prices are controlled, just indicates that some companies are more interested in making money from medical tourism rather than ensuring Malaysian patients have access to affordable medicines.

Fomca strongly supports the government initiative to regulate medicines in Malaysia to make it more affordable to the rakyat. While it cannot be denied that there are many challenges in implementing price regulation of medicines, the efforts of the Pharmaceutical Services Division of the ministry of health must be given the fullest support by all consumers, in their efforts to make medicines more affordable for Malaysian patients and consumers.

Paul Selva Raj is CEO of the Federation of Malaysian Consumers Associations (Fomca).

https://www.freemalaysiatoday.com/category/...edicine-prices/

CAP: Ministry of Health should rethink

zstan — Tue, 17 Dec 2019 15:02:05 +0800

The Consumers Association of Penang (CAP) is concerned over the announcement made on 6th December by Health Minister Dr. Dzulkefly Ahmad on deregulation of consultation fees in all registered and licensed private healthcare facilities.

With the government’s intention to abolish the consultation fee control under the Seventh and Thirteenth Schedule of the Private Healthcare Facilities and Services (Private Medical Clinics and Private Dental Clinics) Regulations 2006, CAP considers this as a rational move if that is meant for the GPs, dentists, and specialists to adjust their professional fees to reasonable rates, especially for GPs since the consultation fee rate has been kept at the 1992 level and it has not been adjusted for 27 years. Often this has been used as an excuse to mark up the drugs dispensed and sold in the private clinics, sometimes outrageously, purportedly just to make the private business viable. Just by taking into account inflation since 1992, the rates in the fee schedule should have been adjusted accordingly and fairly close to 100% increase, in CAP’s calculation.

However, while fee deregulation is taking care of health practitioners’ economic welfare, CAP is concerned that the policy could come with possible negative consequences, especially when healthcare service and products are not ordinary consumer goods.

Information asymmetry between healthcare practitioners and patients is often severe; usually the doctor (service seller) is in a dominant position or authority proposing further treatment or diagnosis, indirectly suggesting ‘what to sell’ to patients. Just by displaying the fees does not mean consumers are empowered or patients are given more choices. Besides the most basic consultation fee, treatment fee could vary greatly (especially true in private hospitals), and often patients do not know what to expect after the first consultation.

CAP urges the government not to deregulate the procedural fee schedule so soon, and to instead monitor and study first the effect of deregulation of consultation fees.

CAP is also concerned that the GPs or the chain-facilities might engage in a cartel or anti-competitive practices that could indirectly result in increasing Out-Of-Pocket (OOP) expenditure for healthcare treatment.

Before the fee adjustment and deregulation, Malaysia is already among the countries with the highest medical inflation rate in the region. In fact, according to Aon’s 2020 Global Medical Trend Rates Report, Malaysia is looking into a gross 14.0% medical inflation in the coming 2020, and forecast to be greater than 5 times the general inflation rate. Therefore, CAP remains cautious over this new policy proposal to deregulate medical fees, urges the government to monitor the private medical fees closely and intervene whenever necessary if this leads to negative impacts on the people’s welfare, eroding instead of empowering consumer’s rights.

If this proposed policy proceeds, private healthcare practitioners and hospitals should not oppose the government’s rational policy for drug price regulation as well as separation of pharmacy dispensary from doctors’ consultation/prescription.

https://consumer.org.my/cap-ministry-of-hea...sultation-fees/