Insurance Companies Avoiding New Drugs, Cancer Advocate Claims

Insurance companies purportedly only want to cover medicines provided in MOH facilities.

KUALA LUMPUR, Oct 25 — Many insurance companies refuse to cover the latest medicines, waiting years instead for drugs to be listed in the Ministry of Health’s (MOH) formulary, a cancer advocate revealed.

MOH, however, mostly buys generics that are only available 10 to 15 years after a drug patent ends, according to National Cancer Society Malaysia (NCSM) medical director Dr M. Murallitharan.

“Everyone is in this to make money. What I don’t like is big multinational corporations who try to not do their duty despite having taken your money,” Dr Murallitharan told a recent forum on advanced breast cancer organised by the Galen Centre for Health and Social Policy here.

“A lot of insurance are now waiting for MOH to approve in the Blue Book,” he said, referring to MOH’s formulary that lists drugs which MOH pays for and provides in its facilities.

“They’re saying that, ‘Look, I’ll wait for the country, I have to follow the same standard regimen as the government. Those drugs I’ll cover, the newest drugs I don’t want to cover’. That’s the problem with some of your insurance schemes.”

Dr Murallitharan said he was told by an MOH cancer control division official that the government would “just wait for all the drugs to be generic”.

The public health physician also pointed out that insurance companies in Malaysia do not have health care professionals at the management level.

“They have nurses, health science graduates doing your claims processing, maybe one or two MOs (medical officers) sitting as head of the claims section, but you have no health economists, and so on and so forth. I can safely say in Singapore, you have one or two. This side of region, ‘tak ada’.

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