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March 4, 2006, Singapore Straits Times Forum page Itemise medical bills to show the costs IN 'High prices of drugs in HDB heartland' (ST, Feb 21) and related letters, we note that the drug prescribed could clearly affect the size of a medical bill, especially when the health-care service rendered is at primary or community level. Our current health-care system has a 'service-first, pay-later' approach where the medical bills, which comprise consultation fee, investigation and medication costs, are revealed just before the patients leave the health-care facility. It is therefore prudent that they be told of their condition and diagnostic assessments and they have the opportunity to discuss the treatment options, including the estimated costs of medication, with their physicians. Patients should take ownership of their health and participate in the understanding and management of their condition. With this, they would be less surprised about their medical bills. Greater bill transparency is also needed. Medical bills should be broken down into individual components. Every service or item provided has a market price attached to it and itemised billing can clarify how the overall bill is arrived at to avoid ambiguity. In Singapore, there are usually generic alternatives available for branded medication. The Health Sciences Authority regulates and approves quality, safe and efficacious drugs, including generic versions. A health-care provider needs to know the choice of drugs available and what is approved for use locally. In the case of Klacid MR, there are about 20 alternative preparations containing the same active ingredient, clarithromycin. Klacid MR tablets (once-daily modified release preparation) may be substituted with twice-daily dosing preparations, which give the same therapeutic effect at a fraction of the cost. Pharmacists are drug experts and they can source and recommend cost-effective alternatives to a more expensive brand. This will reduce significantly the health-care bill on the medication component. Such cost savings become very evident for patients who are on long-term medication for their chronic diseases. An equivalent but more economical drug means patients save on drug costs everyday. The Pharmaceutical Society of Singapore is aware of the escalating health-care costs. We support and advocate the use of therapeutically equivalent medications, including generics, to ensure that patients continue to enjoy quality and affordable health-care services. Pharmacists will continue to work closely with other health-care providers to enhance the cost-effective use of health-care services, particularly safe and efficient use of medication, to benefit the public.
Dr Camilla Wong Comments (0)
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