Straits Times Letter to the Forum May 27, 2006

Some patients have no choice but to buy cheaper medicines across the Causeway
I appreciate the advice to be aware of the risks of taking counterfeit medicines from Jason Humphries, President of the Singapore Association of Pharmaceutical Industries, 'Beware, fake drugs can cause serious problems', and Dr Raymond Chua, Honorary Secretary of the Singapore Medical Association, 'Buy drugs only from well-known pharmacies' (ST Forum, May 20).

But I understand that those who seek cheaper medicines across the Causeway want to stretch their dollar.

There are three reasons why Singaporeans buy medicines from Malaysia or overseas. These patients have no choice in their own country.

Firstly, the prices of branded drugs are tightly controlled by the manufacturers or importers, with high profit margins, because patients are denied the free choice to purchase the equivalent or good generics from open competitive markets like in the US or Europe.

Doctors in Singapore only prescribe branded medicines to be safe and comfortable. The pharmacists here only follow rules and keep records to sell the prescribed drugs as stated by the doctors and charge you the same prices as instructed.

Secondly, the prices of branded medicines from your doctors and from the few privately owned pharmacies in Singapore are the same. It's a waste of time to ask for prescriptions from doctors. Eg, I pay $4 a tablet each day for Plavix, a 'new and better' blood thinning drug, after my bypass operation 12 years ago, as compared to $1.70 a tablet of Ticlid and 5 cents a piece of Cardiprin. Is Plavix so good that it can displace the time-proven Cardiprin?

Health Minister Khaw Boon Wan has said that if the generics costing a fraction can do the job, why pay for the branded?

Thirdly, due to controlled high margins of profits in branded medicines, both doctors and branded medicine suppliers would refrain from prescribing and importing good generics to protect their interests.

The multi-million-dollar pharmaceutical industry has virtually controlled the market for more than five decades. It is high time that shackles be liberated. We need prompt and effective action with mandatory recommended prescriptions for patients to purchase medicines of their choice - either branded or generic.

I urge the Government to pass legislation for separate consultation and dispensing so that patients can choose the cheapest source for their medicines.

Paul Chan Poh Hoi

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