MOH Demands Drug Pricing Transparency, Price Controls ‘Last Resort’

Pharmaceutical companies will be forced to disclose their drug development costs, including for cancer therapies, under the drug price transparency mechanism, says Khairy Jamaluddin.

KUALA LUMPUR, July 27 – The federal government is working on a drug price transparency mechanism to address unimpeded price increases in the pharmaceutical market.

Health Minister Khairy Jamaluddin said the proposed price control scheme is aimed at making drug companies disclose their drug development costs, which will allow the government to set a “fair and reasonable price” for certain medicines.

“The Ministry of Health (MOH) is detailing the implementation of a drug price control mechanism that will be presented as a ministerial memorandum for Cabinet approval.

“I would like to bring a policy that will force pharmaceutical companies to present their drug prices or prices charged for their medicines for diseases like cancer. Because when there is no transparency, we are at the mercy of Big Pharma – we don’t know what the actual cost of developing the medicine is,” Khairy told the Dewan Rakyat on Tuesday.

Khairy was responding to a supplementary question by Jempol MP Mohd Salim Sharif on the MOH’s plan to stabilise raw material prices for medicines to avoid further price hikes and ensure that the prices of selected medicines will not be raised.

Khairy said the government would also consider direct federal control of drug prices as a “last resort”, citing price caps set on Covid-19 vaccines that were sold to the public under the private vaccination rollout that is separate from the public immunisation programme.

“Price control is the last resort. The government does not like to interfere in the market but if it’s necessary, we’ve done it before. For example, the supply of Covid-19 vaccines in the private sector, we’ve capped prices at RM130 to RM180 per dose for two of the vaccines,” said Khairy, who is Rembau MP.

“We are working on this problem so there is no evergreening process, where pharmaceutical companies make the slightest change to their medicine so that their patent can be extended for many years, preventing any generic versions from being produced, and as a result, the price of the medicine remains at a high level,” Khairy added.

CodeBlue previously reported a tripling of out-of-pocket (OOP) health care spending in Malaysia over a period of 15 years, rising from RM7.14 billion in 2006 to RM23.15 billion in 2020, with 15 per cent of OOP spending in 2020 going to pharmaceuticals.

CodeBlue also reported medical experts as saying that eight cancer drugs approved in 2015 had a six-figure list price, namely Tagrisso (US$153,000), Alecensa (US$150,000), and Portrazza (US$137,000) for lung cancer; Empliciti (US$140,000), Farydak (US$119,000), Ninlaro (US$113,000), and Darzalex (US$110,000) for multiple myeloma (blood cancer); and Ibrance (US$118,200) for metastatic breast cancer.

Earlier, the health minister said the MOH had released its buffer stock of paracetamol to 220 hospitals and private clinics as of July 22.

He said paracetamol sales increased by up to 238 per cent in the first quarter this year, compared with the corresponding quarter last year, due to a spike in demand for medicines to treat common cold and flu.

“This high demand has caused a shortage of supply for some types of medicines even though the production of those medicines has been increased by local manufacturers, in addition to increasing the amount of medicines imported from abroad,” he said.

In addition to paracetamol, the MOH will release three more medicines in its buffer stock, namely promethazine for the treatment of flu, as well as salbutamol and theophylline to treat asthma, to private medical facilities.

“We’ve received orders from private clinics and hospitals for these three medicines and we will give them at the purchase cost,” Khairy said in response to Kota Belud MP Isnaraissah Munirah Majilis’ question on measures taken by the government to address drug supply shocks in the country.

Khairy expects the situation to recover by the fourth quarter of this year.

The MOH had attributed the country’s drug shortages to a spike in Covid infections as well as hand, foot and mouth diseases (HFMD) in early 2022.

Other factors include consumers’ preference for certain medicine brands over others, delays in the supply of active pharmaceutical ingredients (API) due to the Russia-Ukraine war and curfew in China, as well as manpower shortages and compliance issues in the manufacturing industry.

CodeBlue previously reported on the medicine shortage problem in Malaysia at length, with scarcities being reported by private clinics and procurement pharmacists at private hospitals since May – much earlier than conventional shortages that typically occur towards the end of the year.

The shortages reported recently extend to several antibiotics; over-the-counter medicines for fever, flu, and cough and cold; children’s syrups, including critical asthma medications; and even seizure and central nervous system-related medication for mental or brain conditions like epilepsy, anxiety, attention deficit hyperactivity disorder (ADHD), and Parkinson’s disease.

The Malaysian Association of Pharmaceutical Suppliers (MAPS), which represents local pharmaceutical importers, noted that Malaysia is particularly vulnerable to global supply chain disruptions because Malaysia is a net importer of pharmaceuticals. Malaysia imports finished pharmaceutical products, as well as APIs and pharmaceutical intermediates that are needed for the local manufacture of drugs.

Following the reports, Khairy issued a statement saying that MOH has opened its medicine stocks to private health care facilities that are facing drug shortages, with a mechanism for private clinics or hospitals to make requests to borrow medicine supplies from MOH facilities.

CodeBlue reported that medicine shortages affect health facilities disproportionately; private clinics and hospitals are more vulnerable to supply shocks due to their leaner inventory compared to MOH facilities. Both MOH and university hospitals also ration prescriptions to deal with drug shortages.

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