KUALA LUMPUR, Dec 16 — Mandatory medicine prescriptions from clinics is not the only factor in patient safety, a doctors’ group told pharmacists.
The Medical Practitioners Coalition Association of Malaysia (MPCAM) said mandatory prescriptions would not necessarily ensure that patients could choose where to get their medications from, as clinics owned by “businessmen-owned” chain pharmacies would send their e-prescriptions to their pharmacies and patients would have to get their prescriptions filled in these pharmacies.
Furthermore, such clinics can also prescribe medicine or other products that are solely distributed by their outlets, said MPCAM.
“Since some businessmen chain pharmacies own their own clinics and can easily get prescription via their e-consultation channel, diagnosis this way may not be done properly and most of the time, this is done merely to get prescription to legalise their trade. This may put patients in danger as their condition is not properly diagnosed,” MPCAM president Dr Raj Kumar Maharajah said in a statement.
“At times, these doctors who are employed by the chain pharmacy owners may be under pressure to prescribe medicine even though he may feel that it is not proper, just like in private hospitals now where doctors are under pressure to do internal referrals and order investigations by businessmen who are hospital owners.”
Dr Raj Kumar also alleged that some chain pharmacies could make deals with suppliers to solely distribute their products to them.
“These monopolistic behaviours ensure that even though a patient may have prescription in their hands, they will not be able to purchase that medicine wherever they want.
“This will cause the patients massive inconvenience and frustration, especially if the pharmacy he preferred to patron is refused supply of the medicine and if the other pharmacies he tries to get the prescription filled are also refused the supply.”
Chain pharmacies, he said, could intercept patients by getting prescriptions from their own clinics after patients were initially diagnosed and treated by other doctors.
“This way, these patients will be able to get their medication without consulting the doctor. These businessmen chain pharmacy-owned clinics may also counter prescribe medicine that are exclusively distributed by their chain pharmacies.”
If there are any prescribing errors or ambiguity, chain pharmacies cannot be made to revert to the original physician who prescribed the medicine, opting instead to get a new prescription from the clinics owned by the pharmacies.
“In summary, if it is mandatory for doctors to issue a prescription, then it should be made a rule that chain pharmacies especially and preferably, pharmacy owners, cannot own a clinic as then, practicing doctors will be forced to literally send their customers to their competitors.”
Dr Raj Kumar Maharajah, president of the Medical Practitioners Coalition Association of Malaysia (MPCAM)
“As seen before, many patients with chronic illnesses and long-term medication have, for many years, been buying their medicines from the pharmacies without seeing their doctor, and ultimately ending up in hospital with organ failure and other complications.
“For some reason the Pharmacy Enforcement team is unable to detect the dispensing of Group B medicines from pharmacies without a doctors’ prescription,” the physician said, referring to pharmacy authorities from the Health Ministry.
Dr Raj Kumar complained about the “clandestine” way the proposed amendments to the Poisons Act 1952, which punished non-compliance with mandatory prescriptions upon patients’ request with incarceration or fines, had bypassed stakeholders and “cleverly slipped into Parliament”.
“The MPS has for long been emphasising on patient safety, while emphasising the need for mandatory prescriptions (over and over again) from GP (general practitioner) clinics, creating an impression that it is the single most important factor in protecting the patient,” he said, referring to pharmacists’ group, the Malaysian Pharmaceutical Society (MPS).
“So many more serious issues on patient safety have been ignored by the MPS and other pharmacy groups, creating suspicion on their objectives, and if they have really thought of these many issues or are they merely worrying the consumer, creating mistrust between the doctor and his patient, to fulfil a bigger agenda.”
Subsequent parliamentary readings of the Poisons (Amendment) 2019 Bill were postponed to next year after physician and dentist groups, including international associations, expressed outrage about the criminalisation of refusing patients’ requests for prescriptions.
