Dispensing separation is to ensure best care, say pharmacists

The star

BY LOH FOON FONG

PETALING JAYA: Dispensing separation is not about taking away doctors’ rights, but making clear the division of professional responsibilities to ensure best care for patients, the Malaysian Pharma­ceutical Society (MPS) said.

Its community pharmacy chapter chairman Lim Kah Poh said the possibility of undetected prescription errors should not be conveniently brushed aside.

“In dispensing separation, a pharmacist will screen through the prescription to ensure there is no error, and if there is any, he should contact the doctor to clarify,” he said in response to the flurry of comments recently over the matter.

Pharmacists are hoping that the “doctors diagnose, pharmacists dispense” system would be accepted by all by April 1.

Doctors are protesting the move while consumer bodies said the decision of where to get medicines should be left to patients.

On Feb 17, Health Minister Datuk Seri Dr S. Subramaniam said dialogue was still ongoing and no decision has been made by the ministry.

On patients’ willingness to pay higher medicine prices at clinics, Lim said patients should be aware that pharmaceutical companies do attempt to influence doctors to promote one product over another, sometimes to the extent of disregarding safety, efficacy and/or price.

Lim, who is also in MPS’ task force against inducement of health professionals, also asked why some health professionals preferred to prescribe pricier “branded or innovator drugs” over generic versions.

“The healthcare system should be designed to safeguard the health of the people,” he said, though admitting that inducement could also apply to pharmacists, thus underscoring the need for policing in this area as well.

Community pharmacist Gan Ber Zin said doctors only attended a one-year lecture on pharmacology in their five-year medicine course.

Pharmacists, on the other hand, were trained from formulation drugs to monitoring side-effects, and would screen every dispensed drug for possible interaction with other drugs, food and other substances.

“There is no justification to delay the implementation of the prescribing and dispensing functions for doctors and pharmacists,” he said.

According to Gan, such separation was already in place in the public sector, while private hospitals were working towards the same.

“Why are private sector pharmacists in community pharmacy practice not treated the same?”.

Medical practitioners: Listen to patients’ views

the star
BY LOH FOON FONG

PETALING JAYA: The Medical Practitioners Coalition Association of Malaysia wants the current system where private general practitioners can dispense medicine to be maintained for patients' convenience.

Its president Dr Jim Loi said that patients’ views should be heard on this.

For example, he said: “What am I to do if a feverish elderly woman comes to my clinic and I have to tell her that I can’t give medicine after examining her because of this dispensing separation and she has to go to the nearest pharmacy, which is one or two kilometers away?"

The Star reported yesterday that pharmacists had hoped that the dispensing separationwould come into effect on April 1 when patients could no longer get their medicine from private clinics but obtain it from pharmacies, if the Health Ministry accepts the proposed “doctors diagnose, pharmacists dispense system”.

While the system may cause some inconvenience to patients, pharmacists said it would help lower the prices of medicine and give doctors access to many more drugs to prescribe.

However, Dr Loi said the system might add to the patient’s cost and time.

Malaysia, he said, should not be compared to the dispensing separation system adopted in Britain or the United States.

“We have no current economic status that allows insurance to cover medical bills, such as the National Health Insurance scheme in Britain, to support that,” he said.

Asked about the benefit of the new system that aims to restrict abuse of drugs by consumers, Dr Loi said that if it was enforced properly, it would be good for everyone.

However, there was no guarantee that pharmacists would not prescribe medicine without a doctor's prescription under the new system, which he said was rampant even with the current system due to the lack of enforcement.

He said major pharmacies had stopped selling medicine without a doctor's prescription in recent years only because they wanted to show good behaviour before the dispensing separation is implemented.

Dr Loi said that “it was important for doctors to be given the right to prescribe as well because they understand patients better”.

He said when a pharmacist did not have a doctor's prescribed drug in stock, he might suggest another drug to replace it and this could pose a problem if they change the prescription.