March 16, 2006 Singapore Straits Time Online Forum

Patented drugs keep medical costs high in S'pore

I refer to Dr Camilla Wong's letter to itemise medical bills to reduce costs (ST, March 4).

Assuming that Singapore follows Western countries where the doctors only see the patients and the prescriptions are dispensed separately by pharmacists, then things have to change here.

A common problem encountered by patients who want their precriptions is the inadequate inventory of many suburban pharmacies. Imagine the frustration of consulting a doctor and then be told that no medicine is available in the pharmacy.

I also do not understand how the costs of medical care can be lowered by separating the consultation fees and the dispensing of medicines.

Pharmacies here dispense mainly patented drugs and keep very little of the cheaper generic medicine which can cost ten times less than the original drugs. The total costs for patients increase exponentially due to this anomaly. In fact, clinics are the ones which are helping to lower medical bills for patients by prescribing good generics.

Yes, there may be at least 15 brands of generic clarithromycin in the market but the experience of doctors is that not all generics are the same.

It is good that generics are now required by law to prove their bio-availablity, ie how pure and how fast the generic drugs are absorbed into the body to reach effective levels compared to the originals.

Which is why we hear often from patients who tell us that certain generic drugs do not work as well as a branded drug that they had used.

Unless we solve the logistical and inventory problems of the pharmacies, separating the consultation, prescription and dispensing fees will result in higher medical costs and more frustration for the patients.

Lim Boon Hee

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