First Rehabilitation hospital in Malaysia



Khazanah Nasional Bhd has launched Malaysia’s first 96-bedded rehab hospital in the heart of Petaling Jaya, Selangor, called the Regen Rehabilitation Hospital.
The hospital is owned by Khazanah (60%) and New York Stock Exchange-listed Select Medical Holdings Corp (40%) that is parked under ReGen Rehabilitation International Sdn Bhd with an initial investment of RM100mil.
It provides crucial tertiary treatment not presently covered in acute care hospitals for patients such as those who are bedridden or who have had a stroke to enable them to regain their mobility.
Regen Rehab’s CEO Sue Lee expects to record a positive earnings before interest, taxes, depreciation and amortisation in two years and expects to break even in 4½ to 5 years.
Both Lee and Select Medical’s executive chairman Robert Ortenzio said there are no plans to park this venture under another Khazanah-led hospital group, IHH Healthcare Bhd
Lee said she believes that this rehab hospital meets a largely unmet demand in the Malaysian tertiary healthcare system presently and is confident insurers would eventually start to cover such treatments in the present healthcare insurance schemes.
“There is no availability of rehab hospitals like us. Many people cannot differentiate the different types of hospitals unlike in the United States where there are many types of hospitals in tertiary care.
“Over here, we only have acute hospitals (for example Gleneagles or Pantai Hospital) and after that, it is only nursing homes. There is a big gap here in Malaysia,” Lee said.
“Whereas in the US, they have acute hospitals, step-down unit hospitals, long-term acute care hospitals, in-patient post-acute care hospitals and then only nursing homes.
“There are actually many other types of hospitals to meet the needs of patients other than just acute care which we are used to here in Malaysia,” she added.
Regen Rehab said it is in talks with insurers at the moment to provide such coverage for policy holders for admission into such types of hospitals.
“Outpatient care is covered by healthcare insurance for physiotherapy and occupational therapy and this is not an issue. The only part that healthcare policies do not cover now is post-acute rehab admissions.
“But having said that, we have had promising discussions with the big insurers here to do a pilot project. We can then demonstrate the quality of patient outcomes received to demonstrate how efficient we are in managing medical costs,” she said.
Pertaining to this matter, Ortenzio said rehab treatment is not well known or well accepted yet in Malaysia and that the level of awareness on rehab treatment is around where America’s awareness was some 15-20 years back.
“This standard of care will eventually be demanded by patients who have had a stroke or those who have had spinal cord, head injuries or even cancer. This group of people will really demand this level of care for good outcomes,” Ortenzio said.
/theSTAR 21-09-2018
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Pharmaceutical Price control forthcoming ?



The mechanism for price control on medicines will be announced next month before the tabling of the 2019 Budget, says Deputy Health Minister Dr Lee Boon Chye.

The Ministry, he said, discussed the matter with the Domestic Trade and Consu­mer Affairs Ministry last month.

“Every year, the price of medicines goes up by 10% to 20% and this is normal. That is why for normal medicines, we try to use generic ones,” he told reporters after opening the Second Inter­national Conference of Pharmacy and Health Sciences here yesterday.

The three-day conference, with the theme “Integrating Research In­novation, Technology, Practices To­wards Sustainable Health”, involved 150 local and foreign participants.

Dr Lee said the price increase in medicines was also influenced by the method used to bring them into the country.

Most of the medicines were imported from the United States and Europe, he said.

He said a study conducted in the United States on 13 pharmaceutical companies found that the price increase in medicines was due to advertisement and marketing costs, instead of research and development.

Note: Meanwhile it is observed that the 3 main Pharmaceutical Associations (namely Pharmaceutical Association of Malaysia (PhAMA), Malaysian Organisation of Pharmaceutical Industries (MOPI) and Malaysian Association of Pharmaceutical Suppliers (MAPS) are not being currently engaged by the Ministry of Health in the said formulation of the pricing mechanism that is to be announced.

/Bernama 11-09-2018

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Fertility and Ageing Population



Other than Malay­sians shunning marriage or the prospects of raising more than one child, the other side of the coin is that there are also many Malaysian couples struggling to conceive.

Lower birth rates and falling Total Fertility Rate (TFR) birth rates are key drivers of Malaysia’s ageing population, and so are the results of higher education and late marriage, leading to couples having fewer children, stated a report by the Statistics Department in August 2017.

The TFR birth rates dipped from 32.4 in 1970 to 16.7 per 1,000 population in 2015, according to the department.

“As women gain higher education and better employment opportunities, the number of unmarried people eventually rises, which is common phenomenon in industrialised countries.

“The effects of late marriage resulted in an increase in the mean age of mother at first birth from 26.6 in 2001 to 27.6 in 2015,” it said.

Many point to women’s entry into the workforce and delayed pregnancy as being key drivers of Malaysia’s falling fertility rate. However, young Malaysians are citing the high cost of living and work commitment as their reason for limiting to one child or not having kids altogether.

The Malaysian population is expected to increase to 32.4 million in 2018. The national fertility rate is projected to decline to the lowest level ever recorded since the formation of Malaysia 55 years ago. 

For every 1,000 population, there are only 15.8 live births expected in 2018 compared to 16.1 in 2017, noted Malaysia’s Selected Demo­graphic Indicator 2018.

It also stated that the overall fertility rate of Malaysian women aged 15 to 49 is estimated at 1.9 children, which is below the replacement level of 2.1 children compared with an average of 6.0 children per woman in 1963. 

This is a stark contrast to the world’s most populated country, China, which welcomed 17 million babies in 2017 amid falling birth rates.
 
Concerns of an ageing population are growing in Malaysia, as people are having fewer children.

The younger age groups are too small to counterbalance the growing number of older people, said an economics expert.

“As more aged exit the labour market and with declining fertility, demand for labour will go up and so will industrial wages. “While Malaysia still has several years before the economic impact of an ageing population becomes apparent, it needs to buckle up. Eventually, we may have to rely on foreign labour or robots or get the elderly to become gainfully employed."

“We will have to cope with a fast-­rising population of retired people whose pensions, if any, will have to be paid for by contributions from a shrinking working population.” For example," Prof Xavier said, "at the current rate of retirement of 20,000 to 25,000 civil servants annually, in 10 years the pensions will more than double to RM63bil and the public pension bill is expected to hit RM100bil by 2050.

Contributory pensions, increasing the retirement age to 65 and limiting the intake of new recruits could be considered in order to ease the pressure on the public purse. 

“An increasing amount of medical and health resources will also have to be shunted to care for the ageing population,” said Prof Xavier. 

China, for example, spends 5% of its gross domestic product (GDP) on healthcare while the United States spends 8.3% of its GDP on healthcare. “We require policy refocus as Malaysia only spends 4.3% of its GDP on healthcare,” said Prof Xavier, adding special programmes for the aged also must be intensified.

Government initiatives, such as the Selangor state government’s RM1,000 wedding incentive for couples who marry before 35, could help increase the fertility rate, he said.

“Similarly, income tax incentive for ordinary child relief, that is now RM2,000, can be increased to RM5,000. The relief for children in higher education can also be increased to RM10,000. 

“Such incentives will partially help defray the cost of raising children. If the intention is to increase our population, then any tax incentives are sustainable in the long run,” he said.

 /theSTAR 11-09-2018
 
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Cancer: Increased healthcare spending



Several cancer support groups have lauded Health Minister Dr Dzulkefly Ahmad's recent announcement for his Ministry to increase healthcare spending from 6% to 7% of the country's Gross Domestic Product (GDP).

The groups said the additional budget will go a long way to solve the problems faced by patients, especially among low and middle-income patients seeking treatment at public hospitals.

"There needs to be investments in the whole spectrum of cancer care - from screening, early diagnosis, timely treatment and good quality palliative care of patients," said National Cancer Society of Malaysia medical director Dr. M. Muralitharan in a statement on Sunday (May 27).

He added that medical innovation in cancer treatment is progressing rapidly but said that such innovations have yet to be made available in public hospitals.

The groups also lauded the Government's healthcare manifesto which focuses on cancer care.

It said projections from the International Agency for Research on Cancer showed that the number of new cancer cases in Malaysia are expected to escalate by 54% from 37,000 cases in 2012 to 56,932 cases in 2025.

They also called on the Pakatan Harapan administration to implement a national health insurance scheme in a transparent and equitable manner.

Both groups urged the Ministry to focus on cancers that are most prevalent with a high risk of impoverishment within a year of diagnosis and invest in strengthening and sustaining good cancer care.

They added that the mindset amongst policy makers and healthcare staff that cancer control is too expensive or a burden to the public health system needs to change.

Meanwhile, Society for Cancer Awareness and Advocacy Kuching president Sew Boon Lui urged Dr Dzulkefly to be inclusive in his approach and engage with patient groups, affected patients and caregivers before making policy decisions.

She adds that Sarawak was in dire need of skilled medical manpower, particularly oncologists, and bigger cancer treatment facilities to cope with rising demand in healthcare.

/theSTAR 27-05-2018 

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Allegations of Drug Supply monopoly



The Government will be reviewing the procurement process of medicines, said Health Minister Dr Dzulkefly Ahmad.

“We are committed to do a critical review to achieve supply chain optimisation. We want to make sure the procurement cost of drugs and other consumables will not be so high,” he told reporters on Monday, June 25 2018.

Dr Dzulkefly said he will make sure issues related to third party concessions or any “monopoly issues” is handled properly and effectively. He said the Government may also buy medicines directly from manufacturers. 

Dr Dzulkefly added that the Health Ministry is looking into pooled procurement with other Ministries, such as the Defense Ministry. “With economies of scale, we will have better bargaining power. This will help to bring down the cost,” the Minister added.

“We want a real open tender system, where there is no collusion and no bid rigging. But this is easier said than done. We will look into how to practice this,” said Dr. Dzulkefly.

Dr Dzulkefly also said the Ministry will leave it to the Malaysian Anti-Corruption Commission (MACC) to investigate the allegations regarding rigging of the open tender process for drug procurement. “Let the law take its course. The ministry will not interfere,” he said.

On June 13, a 12-page document was emailed to Dr Dzulkefly alleging that a monopoly controlling billions of ringgit worth of medicines supplied to the Government was linked to high-ranking officials and companies linked to certain politicians.

It also claimed that the tenders went to six main agents, who were collectively awarded RM3.4bil or 90.93% of the total sum.

During the interview with BFM89.9, Dr Dzulkefly said concessionaires such as Pharmaniaga take 35% in drug procurements given by the Ministry, together with five other companies.

Pharmaniaga was accused of monopolising the supply of medicines to the Ministry.

He said via the open tender process, international pharmaceutical companies through their local subsidiaries bid through a tendering agent.

“Where the Ministry's procurement tenders are concerned, they come in through the tendering agent. This tendering agent is given a commission of 3%,” he said.

 /theSTAR 25-06-2018

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4.2 million of Population have Mental Health issues



About 4.2 million Malaysians are suffering from some form of mental health issue, says Health Minister Dr Dzulkefly Ahmad.

“Based on the National Health and Morbidity Survey 2015 by the ministry, the prevalence of mental health issues among adults above 16 years old is 29.2% or 4.2 million Malaysians,” he said in Parliament.

He also said 2.1 million women had some form of mental health issues.He said 57,570 women had sought treatment for mental illness at government hospitals between 2010 and 2017.

He said 958 government clinics nationwide were involved with screening and intervention programmes which included an ante-natal screening package to help expecting mothers deal with stress.

Dr Dzulkefly said the expectant mothers were also screened to determine if they required treatment to prevent post-partum depression. He said measures such as increasing the duration of paid maternity leave from 300 days to 360 days were implemented to help lessen stress of mothers.

“The Ministry is also urging the private sector to provide lactation rooms and daycare facilities for employees with new born babies,” he said.

For the youths, Dr Zulkefly said Program Minda Sihat Sekolah or Healthy Mental Health for Schools was implemented since 2014. He said students with mental health issues were referred to health facilities for treatment after obtaining parental consent.

His ministry also worked closely with The Befrienders to provide counselling to those with emotional problems, depression or have suicidal thoughts.

 /theSTAR 31-07-2018


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80% of HIV cases due to unsafe sexual practices



About 80% of the 73,557 HIV cases in the country are transmitted through sexual behaviours.
This is contrary to the common perception that drug addicts were more prone to the virus due to sharing of syringes.
Malacca State Health and Anti-Drug Committee chairman Low Chee Leong shared this piece of information in his speech at the “First Cities Getting to Zero HIV 2018” National Conference at a leading hotel here.
Low said Malaysia was committed to the global declaration to achieve the three ‘zeroes’, namely on new HIV infection, deaths due to AIDS and discrimination against patients.
“However, our short-term goal is to achieve a breakthrough in drastically reducing the incidence of infection by 2020 with the collaboration of various stakeholders,” he added.
Health Ministry official Dr Anita Suleiman said the infection pattern had changed dramatically over the past 25 years since the HIV case was first reported in the country, whereby more people are infected with HIV through unsafe sexual practices than drug abuse.
“The reason is due to Health Ministry’s intervention which provided methadone replacement therapy and also distributed sterile syringes to hardcore drug users for free, contributing to significant reduction,” she said.
Dr Anita said on the other hand, the ministry noticed a dramatic increase of HIV infection through unsafe sexual practices.
Melaka has about 3,755 people living with HIV and about 1,138 AIDS patient as of last year.
/theSTAR 08-09-2018

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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