Dengue cases Unabated



The total number of dengue cases this year has reached an all-time high with 120,871 cases recorded as of Wednesday, December 2019 This averages out to about 331 new cases reported every day.
The previous high was recorded in 2015, with 120,836 cases.
In August, Deputy Health Minister Lee Boon Chye cautioned that the number could hit 150,000 by year-end.
The latest numbers were published on the iDengue website, which is run by the Health Ministry in collaboration with the National Space Agency.
The website, which is updated daily, noted that there have been 164 dengue-related deaths up to Nov 30, 2019 which had surpassed the 147 fatalities recorded in the whole of last year.
However, this is an improvement compared to the 336 deaths recorded in 2015.
The iDengue website provides information on hot spots, preventive measures and contact numbers of operation rooms in every state.
/theSTAR 05-12-2019

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Private doctors and dentists' consultation fees deregulated



Doctors and dentists in private clinics and hospitals can soon determine their own consultation fees, following a decision by the Cabinet to deregulate the fee structures and let free market reign.

The consultation fees must be displayed clearly so that patients are aware of the fees before getting treatment.The latest decision will strengthen the consumers' power to choose their doctors.

If patients are not happy with the charges or services received in any of the private facilities, they can lodge a complaint with the Private Medical Practice Control Section at ckaps.aduan@moh.my for further investigation.
Health Minister Datuk Seri Dr Dzulkefly Ahmad, who announced this, said the Cabinet had assessed the matter holistically and comprehensively as well as taken into consideration the recommendations from the National Cost of Living Council.
The Cabinet is also concerned about the need to amend the Seventh Schedule of the Private Healthcare Facilities and Services (Private Medical Clinics and Private Dental Clinics) Regulations 2006, which has not been amended since it was enforced in 2006, he said. 
"As such, the Cabinet has agreed to abolish the control over consultation fees under Act 586.
The abolition of the fee control will include all registered facilities (in the Seventh Schedule) and licensed facilities (13th Schedule), said Dzulkefly.
The fees for GPs and dentists, as stated in the Seventh Schedule, have not changed in 27 years and doctors have been calling for the fee harmonisation as provided for in the 13th Schedule of the regulations when it was revised in 2013.
In 2013, the consultation fee was gazetted for medical officers working in private hospitals under the 13th Schedule,except for GPs and dentists working in private clinics under the Seventh Schedule.
The current fees of RM10 to RM35 for GPs and dentists practising in clinics have not been revised since 1992 while medical officers at private hospitals who have the same qualifications have been charging between RM30 and RM125 per consultation.
/theSTAR 06-12-2019
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2020 Rare Diseases is RM 16.5 mio



The Ministry of Health clarified that the 2020 budget for rare diseases had actually increased by RM500K to RM16.5 mio.
The total budget includes a budget allocation of RM10 mio for 2020, as well as a current provision under Radiotherapy and Oncology activities of RM6.5 mio.
The government has also developed a National Framework for Rare Disease.
To this end, the Ministry of Health had developed the National Framework for Rare Disease to establish a governance committee to integrate the management of rare disease patients in Malaysia, in a comprehensive and holistic manner that includes advocacy for public health education, screening and patient diagnosis as well as strengthening prenatal diagnosis and newborn screening, clinical management, referral systems, data collection and rare disease-related research.
/CodeBlue 06-12-2019

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Malaysia ranks 12th in World Bank’s Ease of doing Business



The "World Bank Doing Business 2020 Report" has ranked Malaysia in 12th position among 190 economies worldwide, an improvement from the 15th spot the previous year, says the International Trade and Industry Ministry.

Minister Datuk Darell Leiking said the improved ranking was due to the public and private sector members’ collaboration and commitment within the technical working groups under the Special Task Force to Facilitate Business (Pemudah) to improve the ease-of-doing-business environment.
“Malaysia Productivity Corporation (MPC)" as the Secretariat of Pemudah works closely with the respective technical working groups to initiate and monitor the implementation of the various improvement initiatives,” he said.
Darell said Pemudah consistently launches improvement initiatives that impact positively on the ease of doing business by promoting regulatory efficiency, productivity and good governance.
He said Malaysia’s improved performance in the Doing Business 2020 Report attests that the on-going reform initiatives are on the right track to further enhance competitiveness, productivity and governance in the ease of doing business as well as to promote investments, which will accelerate national economic development and prosperity.
The Doing Business Report surveys regulations governing business activities in the economies which are then ranked according to their ease of doing business scores based on quantitative indicators of the regulations.
The report measures the processes for business incorporation, getting a building permit, obtaining an electricity connection, transferring property, accessing credit, protecting minority investors, paying taxes, engaging in international trade, enforcing contracts and resolving insolvency.
/MM 24-10-2019
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The Doing Business Report surveys regulations governing business activities in the economies which are then ranked according to their ease of doing business scores based on quantitative indicators of the regulations.



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Global Medical technology & Pharmaceutical MNCs turning to Malaysia



GLOBAL medical technology and pharmaceutical firms are turning to Malaysia as their investment destination, as they chart their mid-to-long term growth strategy across the region.
For biopharmaceutical company AstraZeneca, the focus going forward will be on achieving growth through a science-led innovation strategy, its country president and managing director Dr Sanjeev Panchal said.
In March, it was reported that AstraZeneca will invest more than RM500mil in Malaysia over the next five years for a new headquarters and to roll out new robotic and cognitive technology.
With more than RM500mil in investment across 2019 to 2023 in strategic segments of its business operations, including medical, finance, clinical studies and commercial, the company will bring innovation by expanding its footprint in Malaysia.
“Beyond accelerating our innovation pipeline to patients in Malaysia, AstraZeneca is working with healthcare stakeholders to address gaps in disease management through ‘beyond the pill’ ecosystem a patient-centric approach.
“These includes strong portfolios of medical educations, diagnostics, research, diseases prevent activities and various programmes to increase affordability and access to innovative medicines, designed to achieve better healthcare outcomes for patients in Malaysia.”
Meanwhile, global medical technology company Edwards Lifesciences (Edwards) is focusing on creating more awareness of the services it provides, said Japan, Asia and Pacific strategy and business operations director Erik Ramp.
“In Malaysia, there’s growing awareness of structural heart disease. We work closely with Institut Jantung Negara and they are seeing more people coming in and asking about the devices and therapies that we provide. It’s a positive sign as it means that patients are becoming more aware of the treatments that are available.
“The diseases that we treat are not just exclusively to Malaysia. They can happen to anyone anywhere in the world. Worldwide, treatment rates for heart valve disease are traditionally very low, so it’s good that people are becoming more aware and speaking to their doctors.”
Back in April, it was reported that Edwards will be investing RM100mil in Malaysia over the next five years through its new regional business service centre, which is located at KL Eco City.
“We set up the office here in April 2019 and have grown our headcount from zero employees to 37. We’ve been able to establish a finance, IT and marketing departments to support our operations in Japan, Asia and Pacific, ” said Ramp.
“We expect a lot of our growth next year and the coming years, especially from our businesses in Japan and China. They are two of our biggest growth countries and as that grows, so will our support services here.”
He added that the RM100mil investment will comprise mostly payroll, training and development, travel budgets and capital expenditure.
AstraZeneca Asia Pacific global finance services head Madeleine Roach said the group conducted an in-depth study before deciding on a location to set its regional hub.
“We always do a thorough study of the sites that we pick and where we want to establish. Because of the investment requirements, it needs to become a hub where we can find really good talent.
“We invest a lot in upskilling and developing our people because we want to see our people advance in their careers, ” she said. AstraZeneca will also be rolling out an academy to boost its employee skills.
“The academy will focus on core skills from understanding our systems to our brands in the company, to looking into some technical areas like tax, investor relations and areas that they may not necessarily be exposed to.
“The academy will go live in October, ” she said.
Separately, Edwards’ Ramp said one of the challenges of setting up base in Malaysia is that not many people are aware of the services that the company offers.
“We are dedicated to very focused areas of medical technology. We treat structural heart disease, which is a subset of cardiovascular disease and when everyone thinks cardiovascular disease, they think heart attack. We also have technologies that help in the monitoring and treatment of those with critical illness. 
Tying up with InvestKL has helped Edwards to create that much needed awareness, said Ramp.
“InvestKL has helped us in terms of the talent market here, as well as helping us connect with other multinational companies (MNCs), ” he said.
For AstraZeneca, InvestKL has been invaluable in helping it explore new opportunities and possibilities, said Sanjeev.
“InvestKL has facilitated multiple engagements with government agencies, as well as other MNC’s, hence strengthening our company positioning as one of the preferred healthcare MNC-committed firm to support Greater Kuala Lumpur’s proposition as a regional business hub.”
“Apart from that, with this collaboration, InvestKL has assisted and supported the company to increase our visibility among the stakeholders and directing us to the preferred stakeholders to achieve our target as the biggest healthcare MNC in Malaysia, ” he said.
InvestKL acting chief executive officer Muhammad Azmi Zulkifli meanwhile is optimistic about the prospects of attracting more MNCs like AstraZeneca and Edwards into the country.
“Given the country’s ease in doing business, its transparency, efficiency and being investor-friendly, Malaysia is well positioned to become an innovation hub for MNCs looking to grow their business within Asean.”
/theSTAR 24-10-2019

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"Pharma Most Ethical Industry" claims MOPI



The pharmaceutical industry is the most ethical among various industries, while chemical and fertiliser industries have far worse practices, a group of Malaysian generic manufacturers said.
The Malaysian Organisation of Pharmaceutical Industries (MOPI), a 45-member association comprising mostly local generic drug makers, said the pharmaceutical industry had several codes of ethics, as well as other such codes within each company.
“I worked for 35 years, but in the pharma industry for 12 to 15 years, and I can tell you, among many other industries, the pharma industry is the most ethical industry,” MOPI president Billy Urudra told a seminar Wednesday on good governance for medicines that was jointly organised between the Ministry of Health (MOH), the Malaysian Pharmaceutical Society (MPS), the Malaysian Community Pharmacy Guild (MCPG), MOPI, the Pharmaceutical Association of Malaysia (PhAMA), and the Malaysian Association of Pharmaceutical Suppliers (MAPS).
He also pointed out that some government-linked companies (GLCs) in the pharmaceutical industry have already signed the Malaysian Anti-Corruption Commission’s (MACC) integrity pledge and instituted company policy against bribery and corruption.
According to Billy, PhAMA, which mostly represents multinational drug makers, established its code of ethics in 1978, while the ethics codes of MOPI and MAPS, which represents importers of generics, were drawn up in 2012 and 2013 respectively.
He also pointed out that MACC had found no evidence of corruption in the supply of medicines to MOH in its investigation on a whistleblower’s claim that three tender agents monopolised MOH’s total medicine tenders between 2013 and 2016, worth RM3.7 billion.
“It has put out this unnecessary and tarnished image of the industry,” Billy said.
The codes of ethics in the pharmaceutical industry, he said, cover various issues related to prescription drugs, such as promotional methods, patient confidentiality, and companies’ interactions with health care professionals, like what kind of accommodation and airfare can be provided to them.
Dr Ramli Zainal, senior director of MOH’s Pharmaceutical Services Programme, said enforcement officers and government staff in logistics and pharmacy who deal with the procurement of drugs in hospitals are rotated every three to five years.
“If you look at government procurement, we have a very tight procedure. The Ministry of Finance (MOF) procedure is there. In terms of procedure it’s there, but still the element of human intervention might be there,” Dr Ramli told the seminar.
He added that MOH’s pharmaceutical programme was tightly regulated, with clear standard operating procedure (SOP) and several committees dealing with product registration.
MACC senior assistant commissioner Zakiah Hassan said public procurement was a high-risk area for corruption, noting that there is a “very high” number of cases involving public procurement in the health sector.
“We’re in the process of introducing a new law to deal with ‘ali baba’. The sale of any tenders, procurement, or contracts is an offence,” she told the seminar.
“We’ve brought this up to the government to make it an offence for any bidders to enter tenders but who ‘ali babakan’ the tenders and procurement,” she added, referring to rent seekers.
The government, Zakiah said, will also tighten laws to require companies bidding for government contracts to declare their “beneficial ownership”.
A survey on code of conduct run last May among drug distributors, wholesalers, importers, local and foreign manufacturers, and community pharmacies in Malaysia revealed that majority of companies surveyed did not have their own code of conduct, except for mostly foreign pharmaceutical manufacturers. Out of 211 respondents, only 73, or 35 per cent, had an official company policy that governs company staff’s interactions with external stakeholders and clients.
“Upstream industry players, such as distributors, manufacturers and importers, reported a higher proportion of companies with internal code of conduct,” PhAMA executive director Ewe Kheng Huat told the seminar.
“Foreign-based companies have a higher proportion of companies with internal code of conduct compared to local-based organisations.”
The activities covered in respondents’ codes of conduct included promotional activities, continuous medical education, and fees for services, among others, while the types of interactions covered were with contractors or suppliers, consumers, health care professionals, medical institutions, and patient organisations.
In general, Ewe said, most complaints about ethics in the pharmaceutical industry were related to ensuring proper and fair promotional materials.
Dr Hasenah Ali, director of the pharmacy policy and strategic planning under MOH’s pharmaceutical services programme, said the good governance in medicines (GGM) programme, which is under the Malaysian National Medicines Policy (MNMP), was launched by the World Health Organization (WHO) in 2004 to ensure the provision of safe, quality, effective, and affordable medicines within a best practice environment.
Malaysia was among the first few countries to join the initiative.
Malaysia’s GGM programme aims to strengthen the health system by promoting good governance in the pharmaceutical sector, to prevent corruption by identifying areas of vulnerability, to increase transparency and accountability in all processes related to the pharmaceutical sector, and to promote individual and institutional integrity.
Areas that are vulnerable to corruption in the pharmaceutical sector include medicines registration, promotion, and selection; licensing; inspections; and procurement.
“We plan to engage with other ministries to collaborate further on GGM initiatives, like the Ministry of Defence, Ministry of Education, Ministry of Finance, MACC, Malaysian Institute of Integrity, and Transparency International-Malaysia,” Dr Hasenah told the seminar.
/CodeBlue 01-11-2019

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MoH extends Pharmaniaga's supply concession



Pharmaniaga Bhd says its wholly-owned Pharmaniaga Logistics Sdn Bhd has received a letter from the Ministry of Health (MOH), extending its services for the provision of medicines and medical supplies to MOH facilities.

The services were for an interim 25 months from December 1 2019 to December 31 2021, said Pharmaniaga in a statement today.
Pharmaniaga Logistics is also allowed to continue providing logistics and distribution services to MOH for five years ending December 31 2024.
In the statement, Pharmaniaga says that it remains focused in providing high standards of service and strong operational efficiency to ensure that all key performance indicators are met. In tandem,it is committed to upholding good corporate governance standards and transparent practices guided by its MS ISO 37001 Anti Bribery Management System.

Observatio: "Flip flop by the MoH?"
/NST 19-11-2019


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Patient's choice for Medicines-Source of Supply



The Ministry of Health (MOH) plans to push legal amendments to enforce mandatory prescriptions by doctors upon their patients’ request.

“This policy will empower patients and empower them to make choices about the supply of medicines either directly from their treating physician or through a pharmacist based on a prescription,” Health Minister Dzulkefly Ahmad said in a parliament reply yesterday.

This follows pharmacists demanding last August for doctors to issue prescriptions so that patients can get medicines from pharmacies, as well as for the ability to charge professional consultation fees.

Malaysian Pharmaceutical Society president Amrahi Buang also called for legislation to enforce pharmacists’ consultation fees.

He requested for a review of the current government policy that mandates prescriptions only upon patients’ request — as opposed to dispensing separation — citing 2018 statistics by the Medication Error Reporting System (MERS) under the Health Ministry that found about 72 per cent of medication errors occurred during the prescribing process, of which about 93 per cent was reported by pharmacists.

Note: Could this be the start towards legislating "Dispensing Separation" in Malaysia?

/CodeBlue 01-11-2019

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Price Control may Impact Health Tourism Negatively



Medicine price regulations may affect Malaysia’s medical tourism, a group representing multinational pharmaceutical companies told the government.

“Medical health tourism is expected to reach RM1.8 billion by year-end, registering a 25 per cent growth. The growth is largely because patients from neighbouring countries seek treatment here, due to the relatively affordable and good private healthcare.”

“Our drugs are accessible. We have innovative medicines at affordable prices and I think the figure is a testament to that,” Pharmaceutical Association of Malaysia (PhAMA) president Chin Keat Chyuan told The Malaysian Reserve.

Drug price controls would impact patients’ experience, minimise treatment options, impede access to innovative medicines and reduce Malaysia’s attractiveness as a health tourism destination, he added.

Chin further said the Health Ministry was only zooming in at single-source drugs, large multinational companies and research and development-based firms, with its proposed drug price ceilings.

“It could pull foreign investors away.”

“We do acknowledge that there is up to 900 per cent markup at multiple-source drugs, but this is largely multiple or generic drugs,” Chin pointed out.

“Free market itself will regulate prices and there will be more options for the people.”

According to the Medicine Prices Monitoring 2017 report, the maximum price markup for generics sold in private hospitals reached a whopping 900 per cent, compared to a maximum 117 per cent price markup on originator drugs sold in the same facility. Across all private retail premises, the median price markups on medicines were 108 per cent for generics and 28 per cent for innovative drugs respectively.

The Health Ministry plans to use external reference pricing (ERP) to benchmark drug prices in Malaysia against seven to eight countries by choosing the average three lowest reference prices to determine the maximum medicine prices allowed here.

Price ceilings are proposed at both the wholesale and retail levels, with violations punished by fines or incarceration.

PhAMA has proposed a price transparency mechanism, where industry players will declare their wholesale prices and the government can compare the retail prices among players.

“By doing this, it will be easier for the government to determine which area has been marked up along the value chain. What we want from the government is to not rush their decision,” Chin said, in a bid to cancel proposed medicine price controls.

PhAMA went even further to advocate mandatory wholesale price declarations for all innovative and generic medicines available in Malaysia, beyond the 400 molecules targeted for price controls.

/Malaysia Reserve 04-11-2019

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Growing Malaysia as a destination for Health Tourism



The country’s healthcare and medical sector is expected to attract two million medical tourists in 2020, propped up by the Malaysia Year of Healthcare Travel 2020 (MyHT2020) campaign launched by the Malaysia Healthcare Travel Council (MHTC).
Deputy Finance Minister Datuk Amiruddin Hamzah said the campaign, run in conjunction with the Visit Malaysia 2020 campaign, would be promoting the importance of physical and mental well-being by inviting everyone to seek health and wellness treatment while enjoying Malaysia’s tourism attractions.
“We hope with this campaign, we will gain momentum and secure more travellers. We are expecting two million healthcare travellers, bringing in revenue receipts of RM2 billion and contributing RM8 billion to the gross domestic product (GDP),” he told reporters after launching the MyHT2020 here today.
Amiruddin said the forecast number represented a significant increase from last year’s 1.2 million healthcare travellers, who generated RM1.5 billion revenue receipts and contributed RM6.4 billion to the GDP.
“In terms of revenue, Malaysia healthcare tourism’s compound annual growth rate has been an encouraging 17% from 2015 to 2018,” he said.
Amiruddin said healthcare travel made up some 7.6% of total tourism revenues and was expected to grow strongly going forward.
Amiruddin said MyHT2020 would also be playing the role of a catalyst to turn Malaysia into a high-income earning nation.
“MyHT2020 will be a stepping stone towards creating larger demand for healthcare in Malaysia, hence creating a bigger need for healthcare professionals,” he said. 
“Malaysian healthcare, once known as the ‘Hidden Jewel of Asia’, has been internationally recognised as the Destination of the Year for healthcare travel by UK-based International Medical Travel Journal and the Best Country in the World for Healthcare by US-based International LivIn  
MHTC, an agency under the purview of the Finance Ministry, was established in 2009 to facilitate and grow the country’s healthcare travel industry.
In his 2020 Budget speech to Parliament recently, Finance Minister Lim Guan Eng said that the government would allocate RM25 million to MHTC to strengthen Malaysia’s position as the preferred destination for health tourism in Asean for oncology, cardiology and fertility treatment.
/Bernama 31-10-2019
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Pharmaniaga's concession for medical supply terminated



Pharmaniaga's concession to distribute drugs and medical supplies for the Health Ministry will end on November 30 2019. There will be no concessionaire for logistics and distribution services any more, says Datuk Seri Dr Dzulkefly Ahmad, and, an open tender system would be introduced instead. 
However, to ensure that medical supplies and health services are not disrupted, Pharmaniaga's services will be extended until the Cabinet decides on the mechanism to manage the open tender, which is hoped to be ready by Q1 2020.  
Historically, the existence of a concession company was the result of the privatisation initiative undertaken by Tun Dr Mahathir Mohamad in 1994. The privatisation involved the concessionaire taking over all the assets and manpower of the Government Medical Stores under the Health Ministry. 
Since 2009, the Health Ministry has placed a very strict new terms and KPIs, resulting in substantial improvements in supply, services and distribution
For example, Pharmaniaga successfully reduced the delivery period of pharmaceutical supplies from 60 working days to within seven working days in Peninsular Malaysia and 10 working days for Sabah and Sarawak.
The KPIs also required Pharmaniaga to provide door-to-door service delivery even to the remotest areas in the country.
It was also required to develop pharmaceutical manufacturers and other companies within the ecosystem under the Vendor Development Programme (VDP), through which vendors are able to increase their economy, job opportunities, development of employees, R&D capabilities, technology transfer and other downstream effects.
Pharmaniaga, in collaboration with the Health Ministry, was also tasked to develop, implement and maintain the Pharmacy Information System (PhIS), a homegrown system for all government hospitals and health facilities. Completed in 2016, the system reduces wastage through optimal inventory management, lowers the risk of products being expired and minimises medication errors.
There are optimism, shared, that even with the expected open tender system to be introduced in 2020, Pharmaniaga with its processes, infrastructure and system in place, theoretically, should have no issue in successfully winning the tender to supply.
/theSTAR 31-10-2019

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Budget 2020 - Healthcare



Budget 2020 also stated that there would be an initial allocation of RM 60mil to kickstart pneumococcal vaccine for children.

The initiative is a good start, however the RM 60mil would not be enough to vaccinate all of the 450,000 birth cohort and the cost of refrigeration required to hold the single dose vials.

There is a RM 25mil allocation for the Malaysian Healthcare Travel Council (MHTC)  as 2020 is a Malaysia Year of Healthcare Travel 2020.

MHTC is an agency under the Finance Ministry that coordinates with the various private hospitals in facilitating medical tourists from abroad and it also promotes the country’s medical tourism sector overseas.
Meanwhile, the move to allow an Employees Provident Fund (EPF) withdrawal for fertility treatment such as in-vitro fertilisation (IVF) is lauded. 
The reason for the move is because the fertility rate in Malaysia has fallen alarmingly from 4.9 children per woman in the 1970s to 1.9 children per woman, which is below the replacement level.
There is also an income tax relief of up to RM 6,000 that was announced to include on expenses incurred on fertility treatment which is an expansion of the definition for medical treatment of serious illnesses tax relief category.
It notes that currently some 70% of of the infertile patients are local with international patients comprising the remainder 30%.
/12-10-2019

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Malaysia Health Budget 2020



The Health Ministry has been allocated RM30.6 billion under Budget 2020, marking an RM1.9 billion increase from its RM28.7 billion allocation in the previous federal government budget.
The 6.6% raise in the budget for public health care next year was smaller than the 7.8% increase in Budget 2019.
However, the Health Ministry’s percentage of allocation from the total government budget was bigger than in 2019, comprising 10.3% of the overall RM297 billion 2020 budget, compared to 9.1% out of Budget 2019’s RM316.6 billion.
The Health Ministry received the third biggest allocation, after the Finance and Education Ministries at RM37.8 billion and RM64.1 billion respectively. These three make up 44.6% of total expenditure.
The allocation under services and supplies for the Health Ministry’s operational budget also saw a minimal increase, from RM10 billion in 2019 to RM10.9 billion.
However, the services and supplies allocation under the Health Ministry’s development budget was reduced from RM476.9 million to RM318.1 million in 2020.
Drugs and medications fall under services and supplies. The government will conduct pool procurement of RM500 million worth of medicines across Ministry of Health, Defence and public university hospitals, according to Budget 2020. 
The government would intensify “Buy Made In Malaysia” product campaigns.
To support the local medical device industry, the government will introduce an initiative to encourage local producers to upgrade equipment and tools used in public clinics and hospitals, based on a minimum allocation of 30 per cent.
The government will also allow pre-retirement withdrawals for private retirement schemes (PRS) for the purposes of health care and housing, based on the same terms as the Employees Provident Fund (EPF).
The Health Ministry’s allocation for emoluments increased from RM16 billion for 2019 to RM16.5 billion. 
/11-10-2019

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Top 10 Global Pharma companies in 2019:



The global pharmaceutical industry reached unprecedented heights in 2018, being estimated at an astounding USD1.11 trillion. By 2020, this figure is set to rise to USD1.43 trillion. 
With rising pressure to develop drugs to meet ever increasing global demand, pharmaceutical companies continue to work tirelessly to bring the most innovative and cutting-edge treatments to patients.
Being a research-driven industry, approximately USD150 billion is spent by pharmaceutical companies every year on research and development projects. Out of thousands of compounds, only a small percentage gain regulatory approval to be used by patients to treat disease and improve quality of life. 
However, in 2018, a record number of novel drugs developed by pharmaceutical companies across the globe were approved by various regulatory bodies. A large proportion were approved by the US regulatory body, the FDA, which approved 55 novel drugs and smashed its record for generic approvals (781 up from 763 in 2017).
Although the USA’s market share of the global pharmaceutical industry is worth over USD 341.1 billion, the Chinese, South East Asian, Eastern European and South American markets are beginning to emerge. For example, the Chinese market is rich with preclinical and early-phase drugs, and is a growing nucleus of biotech activity. 
The next few years will see global growth thanks to the increasing wealth worldwide, as well as increasing demand to maintain high levels of innovation to combat unmet medical need.
Proclinical has ranked the leading pharmaceutical companies according to 2018 revenue from their pharmaceutical segment only.  

1) Pfizer  

USD 53.7 billion

2) Roche

USD 45.6 billion

3) Johnson & Johnson 
USD 40.7 billion

4) Sanofi

USD 39.3 billion

5) Merck & Co 
USD 37.7 billion
6) Novartis
USD 34.9 billion

7) AbbVie

USD 32.8 billion

8) Amgen

USD 23.7 billion

9) GlaxoSmithKline (GSK)
USD 23 billion

10) Bristol-Myers Squibb (BMS) 

USD 22.6 billion

/proclinical 20-03-2019

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Merdeka Healthcare Birthday Wishes



Merdeka Healthcare Wishes - CodeBlue with Choe Tong Seng
What health policies should the government focus on as we reach our 62nd year of independence?
CTS: It is time that the country formulates a “National Health Policy” that is reviewed every three years to provide focus and drive the development for the future health care needs, services and structures etc to meet the changing demographics, health care deliveries, disease burden, new medical technologies, resource allocation in manpower and financials etc.
This is also to facilitate in synchronising and/or integrate “public and private health care” development and deliveries for the future, for example health care financing, better management of patient medicine adherence and safety etc.
As at present, different health care sub sector/ stakeholder has its own priority in the development of health care needs. Further, with each change of the Minister of Health, health care priorities often do change as well.
What do you think the government can do better in terms of health care?
CTS: 1) Mutual respect and transparency for public-private partnership stakeholders’ meetings/ dialogues. There is a suspicion by the private sector that often times the meetings/ dialogues are for endorsing the government programmes, rather than a meeting/ dialogue where consensus are agreed upon and then implemented.
2) Regulatory impact analysis should be carried out for any intended policy that may have a long-term impact for the rakyat and the industry, for example the price control and dispensing separation for medicines. Any decision made by the ministry should be objective and with full transparency, with the rakyat and the national interest in mind.
What kind of health allocations are you hoping for in the upcoming Budget 2020?
CTS: The government must allocate adequate financial funding for the health care sector. Over the last few years, only about 4.5 per cent of the GDP is contributed towards health care despite the growth of population, ageing population, changing disease burden, growing NCDs, cost of medicines and new medical technology etc.
Instead of “just looking at cutting cost” for short-term solutions, where the delivery of services of the health care to the rakyat could suffer and deteriorate, the government should, in addition, consider allocating 6 to 7 per cent of the GDP, as recommended by the WHO (World Health Organization) for developing nations, towards the health care sector. A healthy nation is the anchor towards achieving economic growth and stability.
/31-08-2019

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IHH acquiring Prince Court Hospital



IHH Healthcare Bhd is planning to fully acquire Prince Court Medical Centre from Khazanah Nasional Berhad for RM1.02 billion in cash by March 2020.
IHH’s wholly-owned subsidiary, Pantai Holdings Sdn Bhd, inked a conditional share purchase agreement with Pulau Memutik Ventures Sdn Bhd, a wholly-owned subsidiary of Khazanah, for the acquisition of 100 million ordinary shares and 35,176 redeemable preference shares in the private hospital company, representing the entire issued share capital of Prince Court.
“We are pleased to be adding Prince Court Medical Centre to our existing network of 15 hospitals across Malaysia.
“This is a rare opportunity to acquire an attractive and accretive asset in Kuala Lumpur’s ‘Golden Triangle’ that will strengthen IHH’s position in Malaysia while allowing us to capture the growing medical tourism market,” IHH CEO-designate Dr Kelvin Loh said in a statement today.
Prince Court owns and operates a 277-bed private health care facility that provides a wide range of medical, surgical and hospital services in the heart of Kuala Lumpur, such as burns management, cancer, gastrointestinal diseases, interventional cardiology, in vitro fertilisation, nephrology, occupational health, orthopaedic and rehabilitation medicine.
IHH currently runs 14 Pantai and Gleneagles Hospitals in Malaysia. The government-linked corporation’s 2018 PATMI (profit after tax and minority interests) excluding exceptionals increased 73 per cent year-on-year to a record high of RM1.03 billion, and paid its outgoing CEO, Dr Tan See Leng, RM34 million last year.
“This transaction is in line with our refreshed mandate and provides Khazanah with the liquidity for our future investment capital requirements,” Khazanah managing director Shahril Ridza Ridzuan said in a separate statement.
“In addition, Khazanah is confident that Prince Court will further benefit from IHH’s wealth of experience in providing premium health care, whilst solidifying IHH’s position as leading Malaysian health care provider, where we remain a substantial shareholder with a 26.04 per cent stake.”
codeblue/17-09-2019


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Malaysia Elderly Ageing healthily?



Only 11% of Malaysian elderly people aged healthily in 2015, down from 13% from 2002 to 2006, a study has shown.
Dr Suzana Shahar, head of the Centre of Healthy Aging and Wellness at Universiti Kebangsaan Malaysia, said her 2015 research showed that only about 1 out of 10 Malaysian senior citizens experienced “successful” or healthy ageing, which means an absence of illnesses like cancer, diabetes, cardiovascular disease, or stroke; no functional limitation; good cognition or mental health; no depression; good quality of life; and good self-perception on health.
A total of 16% experienced mild cognitive impairment, while 73% had “usual ageing”, which means extrinsic factors alone increase the effects of ageing, unlike “successful ageing” in which external factors play a neutral or positive role.
According to a 1987 study by Rowe JW and Kahn RL, the effects of the ageing process are exaggerated, while the modifying effects of diet, personal habits, exercise, and psychosocial factors are underestimated.
Dr Suzana told a recent roundtable discussion organised by the Galen Centre for Health and Social Policy here on malnutrition that Malaysia’s prevalence of healthy aging at 11% was below Singapore (17.8%) and Thailand (27.5%), but was about the same as the United States (10.9%) and slightly higher than Europe (8.5%).
She also cited a 2011 study by Lee LK et al that found about 20% mild cognitive impairment among the bottom 40% of income earners (B40), higher than the national prevalence rate of 16%.
Only 3% of Singaporean elderly suffered frailty, said Dr Suzana, citing a 2014 study, compared to 7.5% in the Klang Valley in Malaysia. The Klang Valley’s pre-frailty rate was 65%, double that of Singapore’s 32%. Almost two-thirds of Singaporean elderly, or 65%, were robust, compared to just 27.5% in the Klang Valley.
Dr Suzana said her research found that almost 40% of Malaysian senior citizens suffered from cognitive pre-frailty and cognitive frailty. She had also discovered that three to four out of 10 older adults in Malaysia experienced sarcopenia, or loss of muscle mass linked with ageing.
“We found that older Malaysians have no problem with social networking, but they’re not like the Koreans and Japanese which do cognitive stimulation. You can see older adults there play games to improve cognition. But not an awareness for older Malaysians to engage with cognitive stimulation.”
Malaysia, she said, was ageing at a higher rate of disability compared to Australia, with dementia being a major cause of disability among older Malaysians, followed by musculoskeletal and visual-hearing conditions.
“As [a] conclusion, we are entering an ageing nation with little body reserve to be prepared, with little muscle mass, not so good in respect to metabolic condition, biological and brain reserve.
“Poor socio-economic status, mental health and physical function increase risk of malnutrition and poor health of aging Malaysians,” Dr Suzana said.
Malaysia was ageing much faster than other nations, estimated to take only 23 years from those aged 65 and above forming 7% of the population in 2020 to that age group forming 14% of the population in 2043. In comparison, the proportion of the aged rising from 7% to 14% of the population would take the UK 45 years, the US 69 years, and France 115 years, according to a 2015 study by Ismail et al that she cited.
Dr Suzana called for dietary changes and better nutrition, stressing that middle-age intervention was not too late.
“Now we have to focus on the middle age, if we can change something on middle age, we can see some improvement in aged population.”
codeblue/24-09-2019


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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