Affordability important: MOH

29 November 2012, Straits Times

HEALTH CARE; Keep long-term drug costs affordable

HEALTH care in Singapore is not cheap and the high cost of medicines is adding to the burden.

Many older Singaporeans are on long-term medication for diabetes, high cholesterol, high blood pressure, asthma, and other medical problems.

This long-term dependency on medicines can only increase with the country's greying population, and will be a drain on the personal finances of those affected.

In Malaysia, these same imported medicines (not generic ones) are being sold at up to half price or lower. Singapore should be able to do so too.

Apart from the greater overheads and operating costs, there are two other factors which may have contributed to the higher price of medicines here.

First, in Singapore, many drugs are sold only on a doctor's prescription.

However, in countries like Malaysia and Australia, I see asthma and diabetic medication being bought over the counter.

The medical authorities here should review all long-term drugs to see if these can be sold over the counter, especially as we have an educated population.

Pharmacies can maintain a central registry of users of long-term drugs to avoid abuse of the system.

Second, the prescription of drugs allows doctors too much discretion in pricing them.

Patients usually baulk at high consultation fees but seldom take issue with the cost of medicines.

Safeguards should be introduced to prevent overcharging by private doctors and hospitals.

I am all for private doctors and hospitals turning a profit, but this should not be excessive.

The Government and the relevant medical bodies should look into this issue and perhaps develop guidelines on the cost of medicines, the same way medical consultation fees have been set.

It is difficult to compare and quantify the quality of a doctor's medical skill but it is easy to compare the prices of the same medicines in different countries.

Singapore's medical profession needs to do its civic duty and make the cost of medicines affordable.

Raymond Koh

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Reply from MOH

6 December 2012, Straits Times

WE THANK Mr Raymond Koh ("Keep long-term drug costs affordable"; last Thursday) for his suggestions on keeping long-term drug costs affordable.

Prices differ across countries for several reasons. These include pricing practices adopted by pharmaceutical companies, as well as the local costs of doing business in making the drugs available to patients.

The extent of any difference in prices may also vary from one brand and type of drug to another.

While we do not practise price controls in Singapore, we agree with Mr Koh that charges for medicine should not be excessive.

The Ministry of Health (MOH) is committed to keeping health care affordable and has strongly encouraged all health-care providers to make their charges transparent.

In the public health-care institutions, the cost of medication is moderated through bulk purchases of drugs and heavy government subsidies for commonly used medication.

Earlier this year, the Government raised the subsidy for selected standard drugs used in the treatment of chronic conditions to 75 per cent (from 50 per cent) for patients with per capita household income of $1,500 or less, halving the cost for them.

Mr Koh also suggested that the Government review all drugs that are needed for the long term for over-the-counter use, so as to increase access to patients.

Reviews are constantly conducted to allow for easier access without compromising public safety.

Some medicines for chronic conditions require careful adjustment of dosage by physicians for appropriate and safe care, and would hence require tighter controls.

Bey Mui Leng (Ms)

Director Corporate Communications

Ministry of Health