PharmLinked

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

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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

Pharmaniaga's concession for medical supply terminated

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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

Budget 2020 - Healthcare

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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

Malaysia Health Budget 2020

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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

Top 10 Global Pharma companies in 2019:

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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

Merdeka Healthcare Birthday Wishes

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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