MCPG submits proposal to MOH for CP roles in national healthcare
The Malaysian Community Pharmacy Guild (MCPG) has submitted a seven-point proposal for comprehensively including community pharmacists (CPs) in the national healthcare system.
The MCPG’s proposal aims to persuade the MOH to engage CPs in seven areas of focus, which consist of the B40 Health Fund Protection Fund, transition of care, mandatory prescribing, good pharmaceutical trade practice, compounding practices, consumer medicine pricing and new healthcare policy focus (see inset).
According to Loh Peng Yeow, MCPG assistant honorary treasurer, the MCPG has been concerned by the lack of public-private integration between the Ministry of Health (MOH) and CPs, which leads to the underutilization of knowledge and skills in pharmaceutical care services.
“It’s not just bad for the profession, it’s also a disaster-in-waiting for the national healthcare system,” said Loh. “Pharmaceutical care requires qualified pharmacists both in and beyond the hospital to identify, rectify and prevent drug-related problems … such underuse is a waste of healthcare resources spent on over 3,000 CPs trained in academia, internships and Provisionally Registered Pharmacist (PRP) programmes.”
To illustrate the underuse issue, Loh cited recent studies of medication dispensing in community pharmacies, which reported rates from <2/day across 10 community pharmacies in the Klang Valley, to 6.15/month across 20 others. [Int J Pharm Pract 2013;21(1)66–69; Indian J Pharm Sci 2018;80(2):390–395]
Speaking at the recent Pharmacy Renaissance Summit in Petaling Jaya, Loh noted that both local and international studies reported that patients receiving pharmaceutical care from CPs experienced reduced hospital remission rates due to improvements in compliance and quality of care. [J Manag Care Spec Pharm 2014;20(7):722–732; J Am Pharm Assoc 2015;55(3):246–254; Int Res J Pharm Pharmacol 2011;1(3):33–42]
“Conversely, lack of pharmaceutical care means higher hospital remission rates, which leads to an increased burden on national healthcare resources,” said Loh. “In turn, this means less resources for training pharmacists, which means either more inexperienced pharmacists or the need for more [training] facilities to be built.”
In addition to the proposal’s submission, the MCPG will also be pushing for a town hall session this year with the MOH to discuss the points covered.
The MCPG’s seven proposed areas for CP engagement:
1. B40 Health Protection Fund expansion. The fund currently covers only the treatment of 36 major illnesses, which include NCDs such as cardiovascular diseases and cancer. Qualified CPs could increase B40 access to NCD-preventive services such as smoking cessation and health monitoring.
2. Transition of care (TOC). Patients discharged from public hospitals but on long-term treatment could be connected to CPs for medication adherence checking, health education and more localized communal care.
3. Mandatory prescribing. This would uphold patients’ rights to prescriptions and allow CPs to act as a safety net for prescribed medicines.
4. Good pharmaceutical trade practice (GPTP). Access to medicines and fair pricing must be made legally binding to aid CPs in providing patients with pharmaceutical care.
5. Compounding practices. For patient safety, compounding should be highly regulated and legally restricted to pharmacists only.
6. Consumer medicine pricing. Development of price control mechanisms should include the CP community in discussions, as they have direct experience with what their patients can afford and their own minimum operating costs.
7. Shifting healthcare paradigms. Healthcare systems and policies should be directed towards multidisciplinary collaboration between healthcare professionals, including CPs, and a stronger focus on disease prevention and patient safety.