This was reported in a research paper published in 2012, looking at the retail prices of the 10 most used prescription medications in Malaysia and in Australia.
The study looked at the prices charged by 20 pharmacies in Malaysia compared to the prices offered by the 3 biggest pharmacy chains of few hundred stores, which were the Chemist Warehouse, Terry White Chemist and My Chemist.
The drugs were the popular medicines used to treat common medical conditions. Betaloc and Noten for heart disease, Glucovance and Diamicron for diabetes, Lipitor and Zocor for high cholesterol, Norvasc and Adalat LA for blood pressure, Ventolin for asthma and Volteren as pain killer.
The findings showed that the mean retail prices in Malaysia were 30.30% to 148.28% higher than those in Australia. For example, Lipitor, the biggest selling cholesterol medicine in the world, a 20mg tablet cost an average RM5.07 in Malaysia, but only RM3.12 in Australia, difference of 62.5%. Norvasc 10mg, a blood pressure medicine, cost RM3.34 in Malaysia, RM2.17 in Australia, difference of 53.91%. GlucoVance 500/5mg, a diabetic medicine, was RM0.79 in Malaysia but RM0.38 in Australia, difference of 107.89%. Betaloc 50mg, a heart medicine, cost RM0.72 in Malaysia and RM0.29 in Australia, difference of 148.28%!
The other problem in Malaysia is, the retail prices between pharmacies could be more than 5 times different. For example, for Norvasc 10mg tablet, a blood pressure medicine, the highest price RM8.67, lowest price RM1.60. difference of 541%. Zocor 80mg, highest RM6.60 and lowest RM1.20, 550% difference. Lipitor 20mg, highest RM7.17 and lowest RM3.83, 187% difference. The retail mark-ups for medicines was confirmed to range from 10% to 552% in another published survey.
Prescription drug expenditures are one of the fastest growing components of the health services around the world. The purchase of medicine makes up a large proportion of the healthcare budget and account for a significant chunk of the non-personnel cost. Furthermore, for cash paying patients, higher cost resulted in significant lower drug adherence among the poor. We need to make life saving medicines affordable and less of a burden to the people.
Globally different countries regulate the drug prices differently. France and Italy have direct price control. Germany and Japan maintain price control indirectly through re-imbursement under social insurance schemes. In Britain, the National Pharmaceutical Pricing Authority monitors the prices and regulate the profit that companies can make on sales.
For developing countries like Malaysia, 20% to 60% of the total spending on health are due to expenditures on pharmaceuticals. Indeed the cost of the prescription can be ten times the fee of a consultation. In this country, the total market size for prescription and OTC (over the counter) medicine is estimated at RM4.5billion a year. The government budget for Pharmacy and Supply for year 2014 is RM1,506,036,800. A very large amount spent to keep the nation healthy and working. However, we could potentially save few hundred millions a year for the government budget and RM1billion a year for the country if we purchased the medicines at the Australian market price. The problem of higher medicine prices here are due to the failure of the government to impose price control and regulations in this country.
In Malaysia, there is a total lack of price control and monitoring in every stage from the manufacturers, distributors to the retailers as well as in the doctors’ clinics. In 1994, in addition to price deregulation, the Malaysian government approved a privatized drug- distribution system for public health care facility to help reduce the cost. The Government Medical Store was privatised and Pharmaniaga was set up. Unfortunately, while Pharmaniaga is now a public listed company worth RM1.18billion with huge profit of RM61.7million in year 2012, the cost of the medicine increased after that and kept on increasing. Worse still, many medicines were found to be more costly in the private sector with huge price variation. Indeed, the medicine prices have been reported to be escalating even faster than the developed world.
The Malaysian government and the pharmaceutical industry can no longer claim that the prices of medicines are best controlled by the free market economy. We have practised that policy since 1994. The country and the people have been forced to folk out more than ever. The prices of medicines are expected to rise by as much as 30% with the implementation of the TPPA (Trans-pacific Partnership Agreement) and the GST(Goods & Service Tax). I hereby urge the government to set up a National Medicine Pricing Authority to monitor and maintain the medicine prices at the lowest possible level. This is long overdue. With the ever higher cost of living, the least the government can do is to prevent excessive profiteering from the medicines necessary to ease our pain and suffering.