Pharmacists Want Dispensing Separation By 2025

Doctors are against the separation of prescribing and dispensing medicines because GPs’ consultation fees are so low.

PETALING JAYA, March 25 — A pharmacists’ group called for the separation of prescribing and dispensing medicines nationwide by 2025, after aiming to propose this to the Health Ministry by 2023.

Malaysian Community Pharmacy Guild (MCPG) president Lovy Beh noted that separation of prescribing and dispensing medicines by doctors and pharmacists respectively was currently practiced in government health facilities, but not in the private sector.

“Patients have the right to choose where they want to obtain their medication, either from the GP clinic or community pharmacy,” Beh told the Pharmacy Renaissance Summit 2019 organised by MCPG here yesterday.

“Separation of prescribing and dispensing is recognised internationally. It’s for community pharmacists to fulfill their role as a safety net, as a check and balance for prescribed medicines in primary care for the nation,” added the founder of Lovy Pharmacy.

Doctors have long resisted the separation of prescribing and dispensing medicines because the consultation fee for general practitioners (GPs) in private clinics has been fixed at between RM10 and RM35 since over a decade ago in 2006. The 2006 fee schedule was based on a guideline by the Malaysian Medical Association (MMA) back in 1992.

MMA has reportedly proposed that consultation fees of GPs operating shop lot clinic practices be matched with their counterparts working at private hospitals, whose consultation fees were raised to between RM35 and RM125 in 2013.

Health Minister Dzulkefly Ahmad reportedly said last October that the proposal to increase GPs’ consultation fees would be raised to Cabinet, but the fee schedule has yet to be changed.

When asked at yesterday’s conference if a compromise had been reached with GPs, Beh said there was no need to discuss further because many meetings had already been conducted with them.

“Everybody has their own interests,” said Beh.

“Nobody can satisfy everybody. Even Trump, President of the United States of America, he can’t satisfy everyone. Even our own prime minister. We’re not going to make everybody happy.”

Beh explained MCPG’s vision for community pharmacists by 2025 — in which they play a role in the transition of care, medicine therapy adherence pharmacy, medicine uses review, and health referral practice — when the separation of prescribing and dispensing system is finally implemented.

For transition of care, she said community pharmacists should be engaged to provide periodic follow-up care for patients with non-communicable diseases who are discharged from government hospitals.

As for medicine therapy adherence pharmacy, Beh said this should be put into practice in the community pharmacy setting besides the current practice at public hospitals. Medication adherence means that a patient voluntarily takes drugs as prescribed.

Medicines uses review involves reviewing the use and handling of a patient’s medicines at a community pharmacy, patient’s house, or nursing home; while health referral practice is where community pharmacists refer patients to other health care providers and vice versa.

“The ultimate goal is that community pharmacists will be a long-term viable future and is an essential and integral part of the country’s health care system,” said Beh.

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