Fleecing At The Pharmacy
M.G.G. Pillai
The health minister, Dato' Chua Jui Meng, now discovers generic drugs. He says in view of higher pharmaceutical
drug prices, as much as 30 per cent, people should go for generic drugs which he now says is equally reliable. But he
does not say where they could be got. Ask a pharmacy, any pharmacy, in Kuala Lumpur or the major towns, and most would tell you they do not stock them. As your doctor to prescribe generic drugs, and he invariably would not have any in stock. But generic drugs are easily available in other countries without difficulty, and doctors often give
you the option of a branded or generic drugs.
Not in Malaysia. The medical fraternity and the pharmaceutical drug companies discourage it. They are a
powerful lobby in the dispensing of medicine. If the doctors do not stock them, you cannot get them. The doctors
do not stock them because the drug companies give them incentives so lucrative that they ignore the patient's
needs. It is not unusual for drug companies to give the double the drugs ordered for the price of one, which adds to
the doctor's income.
But pharmaceutical drugs cost more than in the rest of the region because of the monopoly shared by a company
controlled by the Prime Minister, Dato' Seri Mahathir Mohamed's son, Mokhzhani Mahathir, and the finance minister
Tun Daim Zainuddin-controlled Renong. No drug company can tender unless a Mokhzani-controlled company is paid a
commission, variously between three and per cent, a commission which should make him laugh all the way to the
bank if it were not for his huge bank loans.
This ensures that drug costs remain high. The Renong-controlled PharmaNiaga also controls the privatised
National Pharmaceutical Control Library, which must test all drugs brought into the control, and can decide which can and which cannot be sold on the local market. If the Prime Minister remains long enough at the helm, his son's venture into the medical field would ensure he would provide all support services of hospitals in Malaysia. He already
controls the Pantai Hospital group. However much the government talks of a fair deal for Malaysians, it is no more than a fair deal for the two groups.
The cost of branded drugs rise so frequently that, like the road tolls, they are beyond the reach of most Malaysians. Common everyday drugs like pain killers are far too expensive. Cardiprin, a specially-concocted aspirin to
thin the blook, which I take, cost about RM9 for 28 here, but I get them from Australia through a friend and there is
costs about A$7 for 100 tables. Aspirin, which is what Cardiprin is, is easily available in the United States for a
few dollars for a bottle of 500. The cost of one branded multivitamin tablet cost the equivalent of 14 sen in India
and RM1.50 here. Price gouging is common in most pharmacies, though they justify it by rising prices.
Life-saving drugs you need to keep you alive, like blood pressure tables, rise so fast so often that many cannot afford it. I cannot now afford, and could not for years, routine checks on my heart -- I have had a heart bypass 13 years ago -- for the costs have become prohibitive -- and that in a government hospital. I am lucky my doctor, in my view one of the best general physicians in Kuala Lumpur, reduces the risk by stepping in as best he can. Medical care is beyond the reach of most Malaysians. The high cost of all medicine makes it a burden for any who is not a government servant or retiree or has group medical insurance.
When the system breaks down, as health and medical services have, the health minister tries to calm down the
growing anger by suggesting alternatives he has no intention to bring about. He provides no explanation why drug prices must rise so sharply as now, why we pay far higher prices than citizens in neighbouring countries, why some drugs used widely is not allowed into the country. A friend orders his vitamins in bulk from the United States until he found he could get them cheaper in Singapore. This particular brand, one of the best known, is not allowed into Malaysia.
All sorts of political and marketing games are played to keep drugs in the hands of a few companies and groups to
keep them costly. There was some form of competition when the two monopolists did not take over the hospital and
medical care services. Not any more. There is a way out of it, but this suggestion would never be allowed to become a fact: insist that when generic drugs of branded drugs are available they must be stocked in every pharmacy or doctor's clinic. The patient then has a choice to what he wants.
I am not impressed with allopathic claims that alternative and native cures are useless or dangerous. They are no more dangerous than the cures they prescribe. I move away from allopathic solutions where possible, indeed I look for other than allopathic cures for most of my ailments. As one who is, by common definition, an old man, these ailments become common companions. I have become allergic to several common allopathic cures for some of them, and resort to traditional methods of cure. If anything, I am the better for it. I am surprised at the number who do think so too. I am lucky in that my doctor has an open mind, and concedes that all that he can do is to help you find a cure. It does not interest him if that be allopathic or traditional.
But this is not an option for many. They depend on drugs that must be bought, especially if they are expensive
and the doctors would not supply them -- as often happens in government hospitals -- and are then caught in this
monopolistic strangle in high drug prices. If the government wants to address this -- it does not -- it must look seriously into taking steps to ensure reasonable medical costs. Dato' Chua can call for more generic drugs to be used, but when his own ministry drags its own feet and the two monopolies have no desire, nothing would change. And so we must adjust ourselves as a man swallowed by a python has to until he is crushed to death.
M.G.G. Pillai
pillai@mgg.pc.my