TCM: Prices Rise!



Traditional Chinese Medicines (TCM) is no longer the cheaper alternative it once was as prices of herbs skyrocketed due to the global economy and high global demand.
As a result of the weak ringgit, it was now more costly to import such medicines from China, said Malay­sia Federation of Chinese Medicine Dealers and Practitioners Asso­ciation Secretary-General Kerk Ee Chan.
He said the price of some herbs went up by as much as 50% after the GST implementation in April, 2015 and the cost continues to rise steadily over the past year.
TCM plays a vital part in Chinese meals like soups besides its medicinal purposes.
“Traders are also feeling the pinch as we have members complaining of some 40% to 60% of drop in their businesses. They are barely scraping through each month,” he said in an interview.
Kerk said there was no sign of the prices stabilising due to the global economy and the weak ringgit, ad­vising consumers and practi­tioners to brace for a continuous increase that was expected to be­­come more acute after Chinese New Year.
“The price increase does not only apply to herbs but also medicinal liquors and ointments, commonly used for tui na (a form of Chinese therapeutic massage), which has gone up by a whopping 150%,” he added.
This led to a negative impact on the development of TCM as there were patients who avoided going to TCM clinics because of the cost.
Southern University College (Southern UC) TCM clinic department head Teo Chee Fung said me­­dicine like the tai zhi shen (a root herb), cost about RM140 per kg which was a sharp increase compared to the beginning of the year when it was sold at RM50 per kg.
He said the wu wei zi or Five Taste Fruit, which improves memory and the nervous system, went up by two-fold from RM60 per kg in January to about RM120 per kg by year end.
As for common root herbs such as dang gui and dang shen, usually used in tonics and soups, he said the prices went up by about 10% to RM110 per kg and RM140 per kg respectively since the begining of the year.
A check at Chinese Medical Halls showed other common herbs increased by about 5% to 10% since the beginning of the year such as the price of jing ying hua (honeysuckle flowers) which went up to RM55 per kg, chrysanthemum flo­wers (RM50 per kg) while red dates went up slightly to around RM10 per kg.
Southern UC TCM management committee chairman Lim Boon Hime said besides the high demand in traditional medicine, another contributing factor was the improvement of China’s economy, lifestyle and standard of living in recent years.
Many Chinese herb farmers have given up agriculture causing a blow to the global TCM industry.

“A trip to a TCM hall or clinic used to cost about RM20 to RM30 but nowadays it is common for the bill to come up to more than RM100,” he said, adding that certain herbs increased by a huge percentage from RM20 per kg to thousands of ringgit.
/theSTAR 27-12-2016
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Ministry of Health destroys RM2mil worth of expired Drugs



The Health Ministry has disposed of nearly RM 2 mil worth of expired or spoilt drugs and medicines over a two-year period from 2014.
Most of the medicines had been returned to government pharmacies by patients under the Minis­­try’s “Return Your Medicines” (PPU) programme, said Health director-general Datuk Dr Noor Hisham Abdullah.
Some of the drugs which the Mi­­nistry disposed of, including anti-venom, were rarely used but Govern­ment hospitals need to have them in stock for emergencies. Other medicines had to be disposed as they had been damaged or spoilt due to disasters such as floods.
Among other reasons were patients ended up with expired or unused medicines was a change or discontinuation of a treatment. In other cases, patients ended up receiving a supply of the same me­­dicine from multiple sources as they might have "followed-up" appointments at different facilities.
Some returned medicines on behalf of patients who had died, while others had expired medicine either because they experienced side effects and stopped taking them or because they did not comply with the prescribed regiment.
The PPU programme was introduced in 2010 so that patients can return their unused or excess medicine for safe disposal by the ministry.
Dr Noor Hisham said the most common form of medicines which were returned by patients under the PPU programme were those used to treat diabetes, hypertension, high-cholesterol and gastritis. 
Among the steps taken by the ministry to reduce wastage was to supply patients’ medicine on a monthly basis. Patients, said Dr Noor Hisham, were also advised to inform their doctor or pharmacist if they still have the same medicine as prescribed at home.
“Patients are also encouraged to bring their medicines from home every time they come for refill so that we only top-up the supply accordingly instead of giving them extra.
“It is important for all parties, including patients and healthcare providers, to play their role in ensuring no wastage of medicines,” Dr Noor Hisham said.
“Patients are advised to be compliant towards their medication therapy while supports from the healthcare providers are available for patients if they have any issues with their medicines.”
Dr Noor Hisham said RM1.8mil worth of medicine were disposed of in 2014, equal to 0.075% of the mi­­nistry’s budget for that year.
Last year, medicine worth RM105,000 or 0.005% of the ministry’s budget were thrown out.
                                                                                                                                                                                        /theSTAR 27-12-2016
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Obesity, Diabetes, Cholesterol, Hypertension



One in two Malaysian adults is either overweight or obese, with the number increasing by four-fold in the last 20 years.

Health Minister Datuk Seri Dr S. Subramaniam said Malaysians are facing a health problem due to their unhealthy lifestyle. "A national health and morbidity survey shows that obesity is prevalent among Malaysians above 18, with the numbers drastically rising."

"The number of obesity cases in 1996 was 4.4% (of the population), rising to 14% in 2006. This rose to 15.1% in 2011 and 17.7% last year," he said in his speech when opening the Fruits and Vegetables Eating Campaign at Malaysia Agriculture, Horticulture and Agrotourism 2016 (MAHA 2016) here Tuesday.

He added some 30.3% of adults suffered weight problems. As a whole, one in two Malaysian adults is overweight or one in five is obese.

"In 2015, nearly half of Malaysian adults or 47.7% suffered from high cholesterol or hypercholesterolemia," he said.

Dr Subramaniam said an unhealthy lifestyle had also resulted in the number of diabetes cases in Malaysia to rise since 1996. "The disease will not be seen now but in 15 years when they come to hospital and end up losing an eye or having a limb amputated," he added.

The survey also revealed that diabetes cases rose from 11.6% in 1996 to 15.2% in 2006 and 17.5% last year.

However, he said there was a slight drop in hypertension cases - from 32.2% in 1996 to 32.7% in 2006 and 30.3% last year.

He noted that these ailments are linked to the unhealthy dietary habits of Malaysians who do not eat enough fruits and vegetables.

"Only 6% of Malaysian adults take enough fruits and vegetables, or two servings of fruits and three servings of vegetables as suggested by the Malaysian Dietary Guidelines 2010," he said.

He said that those who consume more greens and fruits are less susceptible to cancer, by between 5% and 12%.

Dr Subramaniam said the Government has introduced several awareness campaigns and programmes to encourage Malaysians to eat more fruits and greens. This includes the Healthy Cafeteria programme to get food operators to offer more fruits and greens on their menu.

He added that the National Plan of Action on Nutrition Malaysia III, covering 2016 to 2025, will ensure healthier eating habits by Malaysians.


At a press conference later, Dr Subramanian said a survey will be conducted in five years to see how effective the healthy diet campaigns have been.

/theSTAR 07-12-2016

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New iPharmacy business model in Australia offers prescription drugs at cost prices.



"When a patient comes to us for help, money is the last thing on our minds,” is how sydneydrugs.com, a new online subscription pharmacy service which launched this week, sells itself to consumers.

The members-only service provides prescription medications at cost price in exchange for an annual subscription fee of $99, $199 or $449 a month, depending on how many extras you want.
“We’re a platform that gives Australians an opportunity to purchase pharmacy items without paying a profit margin to the pharmacy. We are all about making medications affordable,” the site promises.
Customers scan a copy of their prescription or send it in the post, order their drugs online and later receive them in the mail. Any questions they have about the medication are answered within 24 hours.
The website is the brain child of Sydney pharmacists Lindsey Clark and Sunit Ruparelia, who are both registered with industry regulator Australian Health Practitioner Regulation Agency.
Frustrated with the inflated and unpredictable cost of medications, the duo are undercutting local pharmacies and discount retailers like Chemist Warehouse.
“We don’t have overheads like your regular pharmacies do,” Mr Clark told news.com.au.
“Before Sunit became a pharmacist he was diagnosed with high cholesterol and he was sourcing his medication from overseas because of the prices here,” Mr Clark said.
“Working in pharmacies, we see that the prices vary so hugely depending on where you’re located. People in rural towns with only one pharmacy are having to pay so much, while in urban areas the prices are quite competitive.
Mr Clark cited an example of a woman living in a country town currently paying $25 for her medication. “She’s in a town with one pharmacy, so she has to pay it. But we can sell it to her for $4,” he said.
“We’re just offering an option for those people. There’s a lot of struggling families out there.”
Mr Clark says the premises where the drugs are stocked is regularly inspected by the Pharmacy Council of Australia.
But the main industry body is wary about the website. A Pharmacy Guild of Australia spokesman said patients should be “cautious” about a pharmacy model that sidesteps the Pharmaceutical Benefits Scheme, including its safety net provisions.
“While online pharmacy and prescription services may have some benefit for patients in very remote locations, generally Australians are better served by the network of 5600 local pharmacies distributed all over Australia, dispensing subsidised PBS medicines with a Government safety net,” the spokesman said.
“It seems from the list of medicines on the website that many of the more expensive PBS medicines would not be available under the proposed subscription system, so consumers are advised to be cautious.”
/ news.com.au 25-11-2016

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Halal Pharmaceuticals: New Growth Sector



Malaysia is in the forefront of the global halal Pharmaceutical Industry.  
The certification body, the Department of Islamic Development Malaysia, better known in its official Malay name JAKIM, published the world’s first halal pharmaceuticals standard ie "ISO MS2424: 2012" Halal Pharmaceuticals General Guidelines.
Chemical Company of Malaysia Berhad (CCM) was the first to venture into the halal sector about 17 years ago, from vitamins and health supplements to over-the-counter (OTC) medicines such as painkillers, analgesics, eye drops, cough mixtures, ointments and creams.
In the past three years, the number of halal pharmaceutical players, excluding traditional medicines and cosmetics manufacturers, has significantly increased.
“When we got halal certification in 2013, we were the first, and we now see 20 to 30 companies out of around 70 pharma manufacturers in the country, so the sector has grown quite well,” Leonard Ariff, Group Managing Director of CCM Berhad.
Leonard estimated the overall pharmaceutical sector to be growing by 10 to 12% per year, while CCM’s exports are growing at close to 15%.
Demand is driven at the domestic level by the country’s 31.7 million people, around 60 percent of whom are Muslim, although uptake of halal pharmaceuticals is still low overall.
“What sells the most in the halal segment, at 35 percent of the market, is food and beverage, then ingredients, and pharmaceuticals is 1%. Acceptance is still low at the moment,” said Dr Tabassum Khan, Managing Director of AJ Pharma Holding and Chairman of AJ Biologics, an initiative of the Aljomaih Group of Saudi Arabia, which has facility in Malaysia.  
Malaysia is pushing exports of pharmaceuticals which, according to the Malaysia External Trade Development Corporation (MATRADE), valued at MYR 1.31 bil  (USD 317 mil) in 2015, an increase of 15.8% over 2014.
Exact export figures for halal pharmaceuticals are not readily available, but Malaysia’s Halal Industry Development Corporation (HDC) estimates that the top export markets are the United States and Singapore at around $24.2 mil each, and Nigeria, Hong Kong, and China with around $726,521 each in 2014.
Holding back exports is the lack of mutual recognition of halal certification by regulatory bodies around the world, few of which have the same standards as JAKIM, especially in pharmaceuticals.
At the domestic level there is a general lack of raw materials for the industry, despite the country’s biodiversity, which could be tapped into to develop resource-based biogeneric drugs. 
What is needed for the sector to develop further is greater synergy and economy of scale, such as through halal pharma hubs, bigger market players, and for the global pharmaceutical sector to be more geared towards halal ingredients, which is gradually happening, with global ingredients suppliers like DSM and BASF certifying halal lines.
Currently, in Malaysia, prescription medicines are not allowed to carry halal logos on packaging, but halal references in promotional materials are allowed. Labeling of gelatin is compulsory, to ensure its source of origin is clear.
“One of the factors Malaysia is grappling with is prescription products, since the government is being cautious to avoid patients refusing life saving medication purely because they are unsure of its halal status. This involves a holistic approach to educate stakeholders, and how quickly halal pharma companies develop halal products,” said Leonard.
CCM is moving into larger molecule products such as biologics, and has invested in a South Korean company to push such development.
AJ Biologics is also pushing R&D, recently acquiring Denmark’s Statens Serum Institut (SSI) vaccine production business to develop halal vaccines for EV71 (against Hand, Foot and Mouth Disease) and MCV4 (meningococcal meningitis).
“The biggest motivation for acquisition is to have access to the global vaccine market and to have upstream manufacturing capabilities for our project in Malaysia. The other motivation is to have access to a polio vaccine. Developing an animal source-free polio vaccine would be a major contribution to the Islamic world,” said Dr Khan.
AJ Biologics is expected to start commercial operations in the first quarter of 2018, targeting the Middle East and East Asian markets. “The MCV4 will be the first ever halal certified meningococcal vaccine for all the pilgrims traveling to Saudi Arabia,” added Dr Khan.
/Global Islamic Economic Gateway Oct 2016

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Malaysia Public Hospitals - Increase in Ward Charges in 2017



The Health Ministry will increase its charges for first class and second class wards starting next year, said Health Minister Datuk Seri Dr S. Subramaniam.
 
According to Dr Subramaniam, of the total two million inpatients, 32,000 patients were in the first and second class wards.


Upon hospitalisation, patients are initially placed in third class wards and if they do not request to be moved into the upper classes, they will not be charged any extra fee.

The increase in charges for first and second class wards at public hospitals will not burden patients, said its Director General, Datuk Dr Noor Hisham Abdullah. This was because those who asked to be warded there could either afford it or have insurance or guarantee letters from their employers.

“Presently, the charges for first class ward are very low and this is without the cost involved during treatment. For example, the current charge for first class ward is between RM 30 and RM 80 a day compared to private hospitals which charge between RM 100 and RM 400 a day,” he said.

Other charges, he added, such as laboratory tests, checks and operations for those admitted in the first class ward at public hospitals were also much lower compared to private hospitals.

Noor Hisham gave the example of maternity treatment, which would only cost RM 300 at a first class ward in public hospitals compared to RM 3,000 in private hospitals.

If the maternity treatment invol­ved the use of forceps, vacuum or breech procedures and caesarean operation, he said this would only cost between RM 400 and RM 800. The same treatment at private hospitals would cost between RM 4,000 and RM 15,000.

The Government also exempted senior citizens from outpatient charges and gave a 50% charge reduction if they were warded, adding up to a maximum payment of only RM 250, he said.

Others, such as those with disabilities, financial aid recipients, students, organ and blood donors were also given exemptions, said Noor Hisham.

Beds for first and second class wards, he said, were also limited, with only 2,271 beds for first class and 3,251 beds for second class out of the total 40,748 beds in public hospitals.

“As such, those who choose first class are those who can afford it. The increase in charges for first and second class wards is very minimal,” he said.

The maximum charge for patients admitted in third class was only RM 500, pointed out Noor Hisham.

“Those who cannot afford to pay may also be given exemption,” he said.

/theSTAR 16-11-2016


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Government Annual Medicine Purchase: Budget



The Malaysian Health Ministry spends more than RM2 bil to treat over two million patients a year.

Deputy Health Minister Datuk Seri Dr Hilmi Yahaya said the Ministry is gradually relying more on generic drugs in a move to reduce the amount spent on medical costs.

"At present, the ratio of medicine dispensed is 60% generic drugs and 40% innovator brands. Last year, the ministry spent RM2.2 bil on medicine while RM1.9 bil was spent on medicine as of October this year," he said.

He added that 30% of generic drugs were sourced locally while 70% were imported.

"To ensure that the generic drugs are of quality, a bio-equivalent test is done to determine if their content are the same as those of the original drugs," he said.

He added that the Ministry had recently introduced new guidelines to control the dispensing of medicine to prevent wastage.

He cited an example where previously, a chronic disease patient would be given six month's worth of medicine after each check up but came back for more after three months.


Dr Hilmi also denied that the ministry was facing budget cuts, saying that RM2bil was allocated under Budget 2017.

/theSTAR 16-11-2016

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Budget 2017: Mammograms, HPV vaccines, Shorter Queues, Housemanship



Budget 2017: RM30 mil for mammograms gets thumbs up

The RM30 mil allocation for free mammograms and HPV immunisations will encourage women to go for testing, said National Cancer Society of Malaysia president Dr Saunthari Somasundaram.

She said early detection was key to battling cancer.

“Also, Malaysia is hosting the World Cancer Congress in 2018 and having a budget allocated augurs well in cancer control,” said Dr Saunthari.


In Malaysia, it is estimated that more than 30% of women with breast cancer are diagnosed at the advanced stage (Stage 3) when the chances for successful treatment are relatively low, compared to early stages of the disease.

New option to ease queues in govt hospitals

MALAYSIANS who cannot afford expensive healthcare services but dread the long queues at government hospitals will soon have another option.

Non-profit charitable hospitals will be able to charge the same rates as government hospitals under Budget 2017, thanks to the Government’s collaboration with the private sector and NGOs.

RM20 mil was allocated in the form of loans for the hospitals to buy equipment. The Government also allocated RM110 mil, of which RM70 mil is for medical assistance, benefiting nearly 10,000 underprivileged patients. The collaboration is aimed at reducing overcrowding in government hospitals.


In addition, the National Community Health Empowerment Programme will be expanded at the cost of RM80 mil.

Docs to be given four-year contract

Doctors would be given a four-year contract while dentists and pharmacists a three-year contract under the new scheme announced in Budget 2017.

Health Minister Datuk Seri Dr S. Subramaniam said the scheme, which would come into effect soon, would help the 2,600 doctors who had failed to get housemanship in hospitals.

Presently, doctors are required to do two years of housemanship, while dentists and pharmacists are required to complete one year.

“Demand for doctors in the private sector is still high as there’s a shortage of medical practitioners in private hospitals,” he said.

“Once their contract expires with the Government, doctors can still find employment in the private sector,” he said.

/theSTAR 22,23-10-2016

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Budget 2017: Highlights



Prime Minister/Finance Minister, Datuk Seri Najib Tun Razak tabled Budget 2017 in Parliament on Friday, 21-10-2016
.
The following are the highlights:

* Budget 2017 allocates RM260.8bil, up 3.4% from 2016 Budget Recalibration.
* Government expects to achieve 3% fiscal deficit in 2017.
* Only 2.1 million income tax payers out of 14.6 million of country's total workforce.
* No increase in Goods and Services Tax (GST) for 2017 ie 6%

To appreciate the contribution of civil servants, the following was announced:

- To extend the Fully Paid Study Leave with scholarship to the Support Group, which is currently limited to the Management and Professional Group.
- Quarantine leave up to five days without record for public servants whose children are ill and are quarantined.
- Computer loan facility extension for the purchase of smartphones. Public servants can utilise this once every three years, limited to RM5,000.
- An increase to the limit of motorcycle loan facility available for public servants from RM5,000 to RM10,000.
- To increase the civil servant’s housing loans to RM200,000 and RM750,000 from RM120,000 and RM600,000 respectively.
- To complete 30,000 units of Perumahan Penjawat Awam 1Msia at a selling price of between RM90,000 and RM300,000, which is 20% below market price.
- To extend the contract of service and contract for service officers, expiring at the end of this year, for at least one year.
- To address the issues of specialist doctors exiting and promotion delays, Grade 56 introduced between Grade 54 and JUSA C for medical and dental specialists.
- To appoint the first group of doctors, dentists and pharmacists on contract latest by Dec 2016 due to constraint in permanent post. In other words, nearly 2,600 doctors without housemanship will now serve on contract.

For the rakyat’s well-being, the Government remains committed to implement rakyat-centric projects and programs in urban and rural areas, as follows:

- To brighten villages at night, a total of 97,000 street lights and 3,000 LED lights to be installed at crossroads for 7,500 villages nationwide.
- To enhance connectivity of villages, towns and cities, 616km of village roads and bridges will be built and upgraded with an allocation of RM1.2bil.
- To maintain state roads, a total of RM4.6bil is allocated to all states under the Malaysian Road Records Information System.
- To build and refurbish 17,000 units of destitute and dilapidated houses in remote villages and orang asli settlements with an allocation of RM350mil.
- To increase the supply of clean water with an allocation of RM732mil, targeting 5,200 houses and upgrading the Felda water supply system. A water supply fund is to be established immediately with an allocation of RM500mil to address water supply issues throughout the nation.
- To provide electricity supply in rural areas, targeting approximately 10,000 houses with an allocation of RM460 million.
- The Government is concerned about the welfare of urban residences, especially flats. These rundown flats lack maintenance and functioning lifts.
- The Government will implement people-friendly projects with an allocation of RM800mil, with priority given to local G1 & G2 contractors.
- A total of 69 flood mitigation plans will be continued nationwide with an allocation of RM495mil.
- Government to implement MyBeautiful New Home, especially for the B40 group, with an allocation of RM200mil. At the initial stage, a total of 5,000 units will be built with prices ranging from RM40,000 to RM50,000 per unit. The Government will finance RM20,000, while the remaining will be paid as instalments by each owner.
- A total of 9,850 units of houses to be built under the People’s Housing Program with an allocation of RM134mil.
- A total of 11,250 PPR houses are being built with an allocation of RM576mil. The PPR houses are to be sold at between RM35,000 and RM42,000.

To assist in improving the rakyat’s income opportunities, especially the B40 group, RM275mil is allocated for the following:

- Expanding the MySuria Prog nationwide with allocation of RM45mil. Solar panels will be installed in more than 1,600 houses.
- Expanding the Mobileprenuer Programme by Giatmara with an allocation of RM30mil, targeting 3,000 participants using motorcycles.
- Introduction of agropreneur programs to produce 3,000 young entrepreneurs with an allocation of RM100mil.
- Revitalising eUsahawan and eRezeki programmes under MDEC, comprising 300,000 participants with an allocation of RM100mil.
* RM10bil allocated for subsidy, comprising of fuel subsidies including for cooking gas, toll charges, public transport and various incentives.
* To assist paddy farmers, the Government will allocate RM1.3bil to subsidise price, seeds and fertilisers including hill paddy.
* As an incentive to registered rubber smallholders, the Government will allocate RM250mil for rubber production.
* Government to introduce Rainy Season Assistance with an amount of RM250 monthly for three months in November, December and January.
* Monthly cost of living allowance of RM200 to RM300 for fishermen will be continued, benefiting 57,000 fishermen.

BR1M’s assistance for next year, which will benefit 7 million recipients with an allocation of RM6.8bil, will be increased as follows:

- For households in e-Kasih database with monthly income below RM3,000, it will be increased to RM1,200 from RM1,050 and RM1,000.
- For households earning RM3,000 to RM4,000, it will be increased from RM800 to RM900.
- For single individuals earning below RM2,000, it will be increased from RM400 to RM450.
- Bereavement Scheme to be continued with RM1,000 compensation given to the next of kin of BR1M recipients from households and those in the elderly category.

TVET/SL1M:

* RM4.6bil allocated for TVET educations. Four TVET intuitions to become polytechnics, another four vocational colleges and one more become a training institute for TVET trainers.
* RM220mil allocated to upgrade educational equipment in TVET institutions, as well as RM360mil for Skills Development Fund Corporation.
* Double tax deduction to be given on expenses incurred by private companies to provide Structured Internship Programmes for students under TVET.
* RM50mil is allocated to extend the SL1M programmes by GLCs to 20,000 graduates in 2017 compared with 15,000 graduates in 2016.

For housing, the following was announced to enhance first home buyers’ affordability:

- To provide government vacant lands at strategic locations to GLCs and PR1MA to build more than 30,000 houses at a selling price or RM150,000 to RM300,000.
- To build around 10,000 houses in urban areas for rental to eligible youths with permanent job including young graduates entering the labour market.
- To build 5,000 units of People’s Friendly Home, with the Government subsidising up to RM20,000 per unit. RM200mil will be allocated to SPNB.
A new special “step up” end financing scheme for PR1MA programme, under which, 12,000 units worth RM3bil have been booked.
- Financing will be easier and more accessible to buyers with total loan of up to 90% to 100% with loan rejection rate to be reduced drastically. For example, applicants with monthly income of RM3,000 now eligible for loan of more than RM187,000, will be able to borrow RM295,000.
* Stamp duty exemption increased to 100% on instruments of transfer and housing loan instruments, to help reduce the cost of first home ownership. This exemption is limited to houses with value up to RM300,000 for first home buyers only for period between Jan 1 2017 this and Dec 31 2018.
* Second Generation House infrastructure development, a sum of RM200mil is allocated to Felda, RM100m for Felcra and RM100mil for Risda.

* Tax relief is extended to include purchase of printed newspapers, smartphones and tablets, internet subscriptions and gym membership fees.

* For the development of sports, a sum of RM1.2bil is allocated to the Youth and Sports Ministry.

* For healthcare RM25mil allocated for healthcare programmes and projects including upgrading hospital facilities nationwide with an allocation of RM536mil.

* Government to launch an initiative for ethernet broadband services in public universities to be increased to a max or100GB per second. MCMC to provide RM1bil to ensure coverage and quality of broadband nationwide reaches up to 20 megabytes per second.

* To promote the development of SMEs, the Government will allocate a total of RM75mil to implement programmes under SME Master Plan. A 2% rebate will be provided on interest rates charged to SME borrowers under the SJPP scheme. This rebate is limited to a total accumulated funding of RM1bil which involves an allocation of RM100mil for a period of five years.

Among the incentives for education to help parents reduced schooling expenses, the Government will continue with the following programmes:

- To provide Schooling Assistance Programme of RM100 each to students from families earning up to RM3000, which will benefit 3.5 million students
- RM1.1bil for Hostel Meal Assistance Programme for 365,000 students.
- RM300mil for 1Malaysia Supplementary Food Programme for primary school students.
-  RM1.1bil to include Additional Assistance Payment for school fees; textbook assistance and per capita grant assistance.
- Government to provide matching grants of up to RM50 for accumulated savings in SSPN-i for students in Year 1 in fully-assisted govt schools.
- Book vouchers to be replaced with student debit card worth RM250 which can be used to purchase books, computer accessories and internet access.

In an effort to encourage repayments of PTPTN loans, the following incentives will be given:

- 15% discount on the outstanding debt for full settlement;
- 10% discount for payment of at least 50% of the outstanding debt made in a single payment.
- 10% discount for repayment through salary deduction or direct debit in accordance with the repayment schedule.

PTPTN repayment incentives to be in effect from Saturday, Oct 22 2016 till December 2017.

- Financial assistance to poor families, including General Assistance up to RM300 a month & Children Assistance up to RM450 a month.

- Allocation of RM424mil is provided for senior citizens, including senior citizen socioeconomic assistance of RM300 monthly.

- RM535m, for persons with disabilities, including employee allowance, disabled children training allowance & assistance for PWDs unable to work.

- GST relief for the purchase of aid equipment for registered PWDs without going through Private Charitable Entities.

Among the infrastructure projects announced were:

- Implementation of the new East Coast Rail Line project in phases with an estimated cost of RM55bil.
- Accelerating the implementation of Pan Borneo Highway in Sabah and Sarawak
- RM100bil is allocated to restore the East Coast railway line along Gua Musang – Tumpat that was destroyed during floods.

* RM20mil to be channelled to the 1Malaysia Hawkers and Petty Traders Foundation to provide loans to Chinese hawkers communities.

* Government to expand pre-school programmes to 50 schools with an allocation of RM10mil for Tamil schools.

* Among the measures announced for empowering Bumiputra, the Government will allocate RM100mil to SME Bank to increase opportunities to Bumiputra entrepreneurs. RM300mil also allocated to Tekun to assist small scaled entrepreneurs to develop their businesses including a new scheme called Temanita.

* RM1.8bil allocated for Defence assets maintenance and a sum of RM322mil allocated for personnel deployment at Esscom.

* Home Ministry allocated RM12.8bil including a sum of RM8.7bil for the Police

* To support breastfeeding working women Government to introduce tax relief up to RM1,000 for purchase of breastfeeding equipment.

* Tax relief of up to RM1,000 announced for taxpayers who enrol children aged six and below into registered nurseries and pre-schools.

* Jakim to increase monthly allowance of 15,000 imam in the country from RM750 to RM850. Other incentives announced include one-off payment of RM500 to nearly 16,000 Bilal and Siak for managing mosques and Kafa teachers’ allowance increased from RM800 to RM900 a month.

* RM85mil will be allocated to Permata to benefit 50,000 children.

* Special assistance of RM500 to all public servants while special payment of RM250 allocated for Government retirees.

/theSTAR 21-10-2016

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Budget 2017: RM25 bil for Healthcare



A total of RM25 bil had been allocated for healthcare programmes under Budget 2017.  

The funds would go towards the building of new hospitals and clinics in Perlis, Kuching, Mukah, Jempol, Muar and Johor Baru.   

RM536 mil would be allocated for the upgrading of hospital facilities nationwide. RM4.5 bil will be allocated for the operations of 340 1Malaysia Clinics,11 1Malaysia Mobile Clinics, 959 health clinics and 1,800 existing rural clinics.

RM4 bil would be allocated for supply of drugs, consumables, vaccines and reagents to all Government hospitals and health facilities.  

"The Government will cooperate with the private sector and non-governmental organisations to operate non-profit charitable hospitals based on Government hospital rates," said the Finance Minister, YAB Dato Seri Najib Razak.  

He added that the Government will provide one-off grants worth RM200,000 for the purchase of haemodialysis equipment, with a total allocation of RM40 mil.  


"The Government views contagious diseases such as dengue and Zika seriously and will implement initiatives to prevent and control these diseases," said Najib

/theSTAR 21-10-2016

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Depression is expected to rank No.1 in disability, in the World, by 2020



Depression is now the No. 2 disability in the world.

“It is expected to rank No.1 by 2020,” said Malaysian Mental Health Association deputy president and consultant psychiatrist Datuk Dr Andrew Mohanraj Chandrasekaran.

This means that depression has even overtaken disability due to cardiovascular disease, which is also on the rise globally, he added.




In Malaysia, the National Morbidity Survey 2015 found that 29.9% of the adult population have some form of mental illness. It was 10.7% in 1996.

As for the mental health of children aged between five and 15, the survey registered 12.1% as having issues.

Dr Andrew Mohanraj said this included cases such as conduct disorder, attention deficit disorder, hyperactivity disorder, as well as depression and anxiety.

“It’s quite difficult to detect depression in teenagers because some of them could have turned morose due to hormonal changes or other aspects of growing up,” he said.

However, he was quick to point out a worrying increase in the suicide rate among young people with the primary cause being depression.

“When young people commit suicide, it does not necessarily mean that they want to die, they want to leave the world because they find their situations, in their perception, intolerable and without any other escape,” he said.

Befrienders Kuala Lumpur chairman Mary Raj said there has been “a drastic rise” in younger people contacting the organisation for help.



“The younger generation prefers sending e-mail rather than calling in and we have had a big increase in the e-mail we receive from them,” she said.

Last year, the organisation received 18,445 calls and 2,685 e-mail messages. Of these, 44% of those who e-mailed were aged 30 years and below while 47% did not reveal their age.

Of those who contacted the Befrienders, 24% suffered from mental health issues while 17% had relationship problems.

Other callers, said Raj, faced family problems and job- or sex-related stress but on a much lower percentage than that of mental health issues.

Raj said they occasionally received calls from people on the verge of committing suicide.

“We keep the callers talking as long as possible, to lower the risk of them going ahead with their plan.
“For high-risk groups, we ask if we can call them back tomorrow and if they are willing to give us their contact numbers. We then make follow-up calls to find out if they are okay,” she said

/theSTAR 11-10-2016

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To Boost Health Tourism



More efforts will be put into spurring the nation’s medical tourism industry to achieve its target of RM4.2 bil in revenue by the year 2020.

Deputy Finance Minister Datuk Lee Chee Leong said the nation was strategically located in the ASEAN region to tap the growing number of travellers seeking quality healthcare treatment.

“We are targeting one million health travellers this year which is expected to generate some RM1 bil in revenue. The goal is to see healthcare travellers generating RM4.2 bil by 2020,” he said.

He added that the number of healthcare travellers seeking medical treatment has increased steadily over the last three years, with some 881,000 coming here in 2013, generating RM726 mil in revenue.

This increased to 882,000 in 2014 genera­ting RM777 mil in revenue and last year, 859,000 healthcare tourists brought in RM914 mil.

Lee added that his ministry would liaise with relevant agencies such as the Malaysian Investment Development Authority (MIDA) to look at ways to promote the industry’s growth further.


Malaysia ranks among the top three destinations in Asia for medical tourism with travellers from Indonesia (62%), the Middle East (7.4%), India (3%), China (2.6%), Japan (2.6%) and Australia, New Zealand and Britain (2.5%).

/theSTAR 07-10-2016

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Dengue Vaccine yet to be approved in Malaysia



Malaysia has no immediate plans to follow in the footsteps of Singapore, which has approved the world’s first dengue vaccine Dengvaxia.

Deputy Health Minister Datuk Seri Dr Hilmi Yahya said the ministry was still doubtful of the vaccine’s efficacy in reducing the four serotypes of dengue: Den-1, Den-2, Den-3 and Den-4.

Studies have shown that overall, the Sanofi-manufactured vaccine is effective at reducing dengue by 60% and reducing severe dengue by 84%.

According to a news report, when used against the Den-1 and Den-2 strains which account for three-quarters of the dengue cases in Singapore, the efficacy of the vaccine is 50% and 40% respectively, compared with 75% and 77% for the other two strains.

“We still have to look into this. The vaccine does not have the same efficacy for all the four strains and in Malaysia, we have more of Den-1 and Den-2.

“We are still in the process of registering the vaccine but this does not mean we will use it immediately. We are still doubtful of its efficacy. As it is, we have no plans to use it commercially,” he told reporters at a press conference at the National Heart Institute (IJN) here yesterday.

According to statistics from the ministry’s Crisis Preparedness Response Centre, 186 dengue-related deaths were recorded between January and Oct 1 this year.

Earlier, Dr Hilmi launched a first-of-its-kind collaboration in Malaysia between IJN and global payments technology company Visa.

With the partnership, IJN offers up to 25% exclusive discounts on all its six wellness packages to all local and international Visa cardholders. Cardholders need to produce their credit or debit cards upon registration.

IJN chief executive officer Datuk Seri Dr Mohd Azhari Yakub said the partnership would further boost Malaysia as the preferred medical tourism destination.

“Our cost here is very competitive compared with other countries because the Government controls the rate,” he said. The promotion starts immediately and lasts until December next year.

/theSTAR 07--10-2016

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Hospital in Kuantan to cater for heart patients



Heart patients can look forward to better care at a new facility in Kuantan, Pahang.

The KPJ Pahang Specialist Hospital, which opened officially in Tanjung Lumpur on 6th October 2016 will have specialists to attend to such patients.

KPJ Healthcare Bhd chairman Abdul Wahab Baba said the hospital would be developed for healthcare tourism.

The hospital will be able to cater to between 200 and 250 patients. “Presently, we can only provide 110 beds but we will increase the capacity soon,’’ he said.

The hospital was built at a cost of RM110mil, with RM70mil more spent on its clinical information system. He said there had also been an increase in the number of patients needing oncology and kidney treatment in the east coast. “This has prompted us to provide such treatment at our centre in Alor Akar,’’ he added.

/the STAR 07-10-2016

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Day Care Procedure & Surgery Encouraged



Health Insurance providers should do away with mandatory admissions at hospitals – as a requirement for medical claims – because many procedures can be done within a day now.

Most public hospitals now carry out minimal invasive surgeries which require shorter hospitalisation to maximise the use of resources and reduce cost.

But insurance companies do not reimburse patients who are not admitted as a matter of policy.
Health Ministry director-general Datuk Dr Noor Hisham Abdullah said insurance companies may not understand the concept of Day Care Procedures or Day of Surgery Admission – where patients come in on the day of the surgery and are discharged either the same day or the day after.




Previously a patient would be admitted two days before a procedure and discharged after two days – making it a total of five days which may not be necessary, he added.

“We want insurance companies not only to reimburse but encourage day care procedures. This is the message we want to send to them,” he said after delivering his opening remarks at the Ramsay Sime Darby Health Care Group Specialists Conference.

While some companies are considering the move, he said, others were reviewing their process after engaging with the Health Ministry.

Resources are limited at both public and private hospitals, he said, adding that Malaysia wanted to have 2.5 beds for every 1,000 people instead of the current ratio of 1.9:1000.

Currently public hospitals have 40,000 beds and there are another 20,000 at private hospitals. The 16,000-bed shortfall for Malaysia’s 30 million people, he said, could be eased with day care services.

He said public hospitals already have the infrastructure and know how but only 10% of all operations are carried out under day care unlike 70% in the United States and 60% in Britain and Germany.

“We are still behind. The best centre we have is in Ipoh where between 40% and 45% of procedures are carried out under day care.”

Dr Noor Hisham wants other public and private hospitals to step up day care procedures.

He cautioned against the practice of patients dictating how long they wanted to stay in hospital for minor procedures – such as a removal of a lump in the breast – because they had insurance coverage.

“It’s not the patient’s choice to stay longer because a private hospital is not a hotel,” he said.

/theSTAR 26-09-2016



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Apex Healthcare: Expanding Manufacturing Capacity



Apex Healthcare Bhd’s wholly owned subsidiary Xepa-Soul Pattinson (Malaysia) Sdn Bhd will be constructing a new oral solid dosage manufacturing facility (SPP NOVO) that will cost RM68 million on its land in Malacca.
SPP NOVO will be a newly constructed stand-alone facility adjacent to Xepa’s current manufacturing facilities on the same campus at Cheng Industrial Estate. The estimated cost of SPP NOVO includes production machinery and an integrated multi-storey carpark.
“The construction of SPP NOVO will be funded through a combination of internally generated funds and external borrowings. At this juncture, the company has not finalised the terms and quantum of borrowings required,” Apex said in a stock exchange filing.
Xepa is a leading manufacturer of off-patent pharmaceuticals in Malaysia. Its current production facilities for oral solid dosage forms, designed and commissioned in 1996, are reaching optimal designed capacity and cannot be further retrofitted economically to increase output.
The construction of SPP NOVO is expected to commence in the fourth quarter of 2016 and commissioned in the first half of 2018. Detailed engineering design has been completed and tenders for construction and equipping are expected to be issued in the current quarter.
“The board of directors of Apex is of the opinion that SPP NOVO is a vital infrastructure that will enable Apex to execute and achieve its strategic plans for the future. It is in the best interest of the company.”
As of Sept 15, 2016, Xepa has secured preliminary approval from the Centre for Compliance and Licensing, National Pharmaceutical Regulatory Agency, Ministry of Health for the design and layout of SPP NOVO.
/theSTAR 16-09-2016

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Shortage of specialists in Cardiology: Malaysia



There are not enough heart experts in the country.

Its deputy Director Ggeneral, Ministry of Health, Datuk Dr S. Jeyaindran said presently there are only about 20 experts for each of the heart-related fields covering all seven heart centres nationwide, and that it needed at least double the number.

"In total, we only have about 20 experts each for cardiology, anesthesia, and heart surgeons. It is not enough, we are short-handed. The problem is that the figure is too low, while the number of cases is too high.

"We need about 50 to 60 experts for each of these fields. At least two times the number what we have now."

Jeyaindran, however, said the Ministry would send chronic heart patients, especially children, to India for emergency surgeries if the situation calls for it, while others will see their waiting time (for a surgery) cut short if their situation get critical.

According to him, the current waiting time for patients hoping to get a surgery in Serdang Hospital, for example, is up to ten months.

He added that the ministry is also in the process of establishing a heart centre in Serdang Hospital, which would be under the purview of the ministry, offering heart surgeries for a mere RM500.

"The Centre is expected to be completed by year 2020," he said.


/theSTAR

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Shortage of Occupational Therapists in Malaysia



“In Malaysia, we have around 1,800 occupational therapists but we are required to serve a population of about 32 million. That is a ratio of 1:17,777,” Malaysian Occupational Therapy Association president Mr Soh Say Beng said.

This rate is three times below the global average of occupational therapist-to-population ratio of 1:5,000

Patients in the Klang Valley are in a better position as it has the largest concentration of occupational therapists in the country.

Among others, occupational therapy is required to help surgery patients regain mobility of their limbs or to help children with learning disabilities.


Though all major public hospitals have their own occupational therapists, Soh said the teams were small and the waiting time to receive treatment could be up to two months. “Ideally, patients should receive OT intervention within a week.The longer you wait, the patient’s muscle grows weaker from disuse; their limbs become still and their motivation drops drastically,” he added.

The UMMC’s department of rehabilitative medicine, where Soh works, has 103 OTs and is the largest and most established rehabilitation centre in Malaysia.

“District hospitals and health clinics are not well staffed with OTs. It makes it harder for us to reach out to those who need treatment,” he said.

At present, many Malaysians who suffer physical or mental impairment are unable to return to work, ending up staying at home under their families’ care.“Our task is to get them to regain their independence, so that they can lead a productive life,” he said.

Students of occupational therapy are being offered jobs even before their graduation, said Dr Chai Siaw Chui, who lectures at Universiti Kebangsaan Malaysia’s Occupational Therapy program.

“If you have a qualification in OT, you can go anywhere,” she said, referring to the versatility of the profession. Apart from public healthcare, she said OT specialists could choose to work in pediatric and geriatric care, mental institutions, city councils or the Social Security Organi­sation.

The starting salary of OTs in public service is usually at RM2,429 (Grade U41) while doctors start at RM2,947 (Grade UD41)

Dr Chai said occupational therapy students were trained to seek creative solutions to their patients’ problems, which range from psycho-social issues to having an ill-equipped working environment.

The ideal ratio, according to Dr Chai, was one occupational therapist for every 2,000 people.

About 90% of the 230 graduates produced annually in the country end up working in the civil service, taking up positions in public hospitals and in the Health Ministry, said Dr Chai.

Those numbers, she said, were not enough to fill up rehabilitative roles, preventing OTs from reaching their potential of promoting health and preventive therapies.

Dr Chai, who specialises in hand therapy, explained that OT played an important role in ensuring surgery patients regain mobility of their limbs.

“Let’s take the case of a patient who has had his hand reattached by surgery. The surgery offers a 50% chance of him regaining his mobility. Another 50% depends on OT,” she said.

She said OTs would also help children with learning disabilities.

Though some functions of OTs overlap with physiotherapists, the latter work primarily with helping individuals recover from injuries with a combination of massage and exercise.


/theSTAR 18-09-2016 


Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Counterfeit Drugs in Malaysia: Statistics



The Director of the National Pharmaceutical Regulatory Agency, Ministry of Health, noted that based on the volume of counterfeit drug seizures made by the Pharmaceutical Enforcement unit, counterfeits account for between 3-6% of medicines distributed in Malaysia.

The Pharmaceutical Association of Malaysia found, in 2015, that approximately 5% of prescription medicines are fake, including eye drops, inhalers and medicines for erectile dysfunction (ED).

ED medicines are among the most frequented group of counterfeited medicines in the Malaysian market, which is estimated to account for 30-40% of all counterfeits.

As of 2013, counterfeits drugs accounted for 10% of the world's medicines, with an estimated annual growth rate of 13% as reported by the international law firm, Baker and McKenzie. In addition around 40% of illegal pharmaceuticals are said to originate from Asian countries according to a 2011 report by a US based Pharmaceutical Security Institute.

The 2008 European Alliance for Access to Safe Medicines (EAASM) Report also found that 62% of medicines purchased online were either fake or substandard while over 90% of online pharmacies supplied prescription-only drugs without prescriptions from a name verifiable pharmacist.

/MIMS DOCTOR 15-31 July 2016_12-08-2016

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