Healthcare costs in Malaysia are rising, and one of the main reasons is the high price of medicines. A policy that is often discussed as a possible solution is dispensing separation (DS). This means doctors will only diagnose and prescribe medicines, while pharmacists will be the ones to supply the medicines.
Right now in Malaysia, especially in private clinics, doctors can still give medicines directly to patients after a consultation. But many believe this system can lead to doctors prescribing more than necessary, as they also profit from selling medicines. In many developed countries, DS has already been in place for years to make healthcare more transparent and safe for patients.
What Happened in Korea and Taiwan?
South Korea introduced DS in the year 2000 to reduce overprescribing and the rising cost of medicines. After the policy was introduced, the cost of medicines per visit went down. However, other charges such as consultation fees and dispensing costs increased. In the end, the total cost of healthcare for patients did not go down.
Taiwan started DS around 1997. Studies showed that the number of medicines prescribed and the cost per visit went down, especially in clinics that did not have their own pharmacy. But again, the total cost of healthcare remained mostly the same. These cases show that while DS can reduce the cost of medicines, it does not automatically reduce the total cost of care unless other changes are made.
What About Malaysia?
If Malaysia wants to introduce DS, there are some important points to consider. Right now, many patients only pay one fee at private clinics. This includes both the consultation and the medicine. With DS, patients may have to pay twice – once to see the doctor and again to get their medicine at a pharmacy. Without price control or proper insurance coverage, this can make treatment more expensive for patients.
Small clinics, especially in rural areas, depend on income from selling medicines. If DS is introduced without financial support, some clinics may not survive. This will make it harder for people in remote areas to access healthcare.
Another issue is that some pharmacies now offer health screening and even give medicines without proper prescriptions. If this continues without control, it can lead to wrong treatments and higher long-term costs due to complications. So, there must be stronger enforcement to ensure only qualified doctors make medical diagnoses and that more medicines can only be given with a proper prescription.
A Policy Made in Desperation?
There is growing concern that the push for DS may be driven less by long-term healthcare planning and more by political pressure. When the cost of living goes up, people expect the government to act. In such times, introducing a policy like DS may be seen as a quick way to show that something is being done to help reduce costs, even if the real effect on total healthcare spending is small. While the intention may be good, hasty implementation without a full understanding of the consequences can make things worse.
What Can Be Done?
DS is not the only way to control healthcare costs, but it can help if introduced correctly. It must come with other changes such as:
• Clear and fair consultation fees,
• Strong rules to ensure only doctors can diagnose,
• A longer list of prescription-only medicines,
• Better healthcare financing, like insurance or subsidies,
• And more pharmacies in both cities and rural areas.
Conclusion
Separating prescriptions and medicine supply is not an easy step, but it is worth thinking about for a better, safer, and fairer healthcare system. We can learn from countries like Korea and Taiwan, but we must adjust the plan to fit our local needs. If done carefully and supported by proper policies, DS can bring long-term benefits for patients and help improve the whole healthcare system in Malaysia. But it must be done for the right reasons, not just as a quick response to public pressure.