Excerpt of Speech by Ng Cheng Tiang, President, Pharmaceutical Society of Singapore on occasion of the Opening Ceremony of the 19th Singapore Pharmacy Congress.
Good evening to all.
I am very excited to be in this gathering as part of the group of practitioners, scientific and business community who have one thing in common, ie. we are in the business of looking after the health of people in Singapore, however direct or indirect our role might be.
With a physically fit population, there will be a healthy workforce to toil for the economic prosperity of the country. Additionally, pharmaceutical and biomedical industry has always been one of the major economic drivers to propel the country’s economic health to be among one of the most enviable success stories in the region.
A). The Coca-Cola Story
1. Way back in May 1886, a pharmacist in the US called John Pemberton formulated a special concoction of syrup which he sold to the public. His first year’s sales totalled $50, but he spent more than $70 in business expenses. This pharmacist didn’t’ quite make a profit after the first year in business. The following year, another pharmacist by the name of Asa Candler bought the formula from the inventing pharmacist for $2,300. By now, you must be wondering if pharmacists do have good business sense?! Indeed, Candler turned the situation around and business grew 4000% in ensuing years. Thanks to these 2 pharmacists, they brought Coca-Cola to planet earth, and nearly 5 billion people on earth now drink Coca-cola!
B). The Pharmacy Story in Singapore
2. There are close to 1,500 registered pharmacists in Singapore.
a. About half of them work in private or public sector with no direct dealing with patients. Their roles are more commercial, managerial, administrative, R&D, academic, regulatory, compliance, production, QA etc. It is a long and diverse portfolio. They are largely responsible for the supply, business and policies of the drug products. Quality of the products is thus high on their agenda.
b. The other half of pharmacists work in environments that deal with patients directly, ie. the hospital, polyclinics and retail pharmacies. They are the ones who will ensure that quality healthcare services are delivered to the clients.
Collectively, these two groups of pharmacists aptly put together the meaning of this year’s Congress theme: “From Quality Medicines to Quality Healthcare”
C). Pharmacists Who are in Non Patient-care Sector
3. In every healthcare system, if we take away the drugs component, it’s like being in a soccer match without the football! Drug industry is a highly disciplined, knowledge-intensive and extremely regulated business. There are many stages in the lifecycle of drug project, ie. R&D, clinical development, registration, production, supply chain, commercialization, procurement, usage, drug safety monitoring etc. There are strict regulatory controls at every phase to ensure that quality, safety and efficacy of the products are upheld at all times.
4. Many pharmacists and pharmaceutical scientists work in these fields. Together with various stakeholders, they are responsible for the distribution and supply of both innovative and competitive generic products so that our healthcare system and public can have access and options to the various QUALITY MEDICINES.
D). Pharmacists Who are in Patient-care Sector
5. Pharmacists in patient-care sector are the most visible group. The come in direct contact with patients and their family and they are committed to providing QUALITY HEALTHCARE SERVICES.
a. One notable example is: A number of pharmacists in most public hospitals are, in collaboration with doctors and nurses, managing patients who need anticoagulant, asthma, cardiac, lipid and smoking cessation treatments. This complements the doctors or nurses whose time can be better utilized to focus on more complex and emergency cases. In the first 6 months of 2006 alone, more than 5,000 cases of anticoagulant were reviewed and managed by pharmacists in our public hospitals.
b. Another example is the medication review and reconciliation. In simple terms, it means an audit of the patients’ medication usage. Through this effort, pharmacists can find out what medication the patients take, how, when and why do they take them and to assess the compliance and outcome of the intended treatment. Deviations from the treatment plan and expected results have to be investigated further; eg. there could be intolerable side effects, patients can’t afford expensive brands of drugs, duplication of order, omission, drug interaction etc. Many expensive diagnostic tests, specialists’ consultation & investigation fees can come to naught if drug therapy failed to realize what it was intended to.
c. A medication review and reconciliation exercise conducted on 344 patients recently has shown that such review has resulted in more than $66,000 cost avoidance otherwise needed to manage complications. There would be additional economic impact in the form of loss of productivity but these costs were not quantified. We will be conducting a large scale island-wide campaign from 22-Oct to 2-Nov in conjunction with Pharmacy Week. Most retail pharmacies, polyclinics and hospitals will be participating.
d. In a separate study in one of our public hospitals, a cost saving of approximately $800,000 was achieved annually through the involvement and interventions by pharmacist in optimizing the usage of drugs in our patients. This was a conservative estimate and we will attempt, in our extremely busy work schedule, produce more data and analysis to report in the future meetings.
E). The Changing Healthcare Scene
6. The recently amended and passed Pharmacist Registration Act has added a number of important changes. These will prepare pharmacists and the profession to advance to the next stage. Continuing Pharmacy Education will become mandatory. The Singapore Pharmacy Board will be restructured to become Singapore Pharmacy Council with greater professional and disciplinary oversight. The introduction of Specialist Pharmacist Register will enable pharmacists to be officially recognized. We believe these changes will enhance the competency and the quality of the services provided by pharmacists.
7. With an increasingly educated population, more Singaporeans are becoming more health-conscious. They are making visible efforts to adjust their lifestyle. Self care and self medication is becoming more popular. We will continue to hold dialogues and discussion with the Health Sciences Authority and the relevant stakeholders to review the forensic classification of our medications in Singapore. In the US and Europe, the trend is heading towards down-regulating a number of drugs which have had good safety profile, and Pharmaceutical Society of Singapore would be happy to work closely with HSA in such review process.
8. We have always been advocating transparency of healthcare bills, and are very privileged to be able to work with the Consumer Association of Singapore in such initiatives. We recently worked on a project which aimed at to heightening the awareness of our healthcare consumers about their rights, and to conduct and publish a price survey of close to 300 different medications commonly used in chronic illnesses. The news was given very prominent media coverage and the prices were posted in both CASE and PSS websites.
9. All 4½ million people in Singapore are healthcare consumers at certain stage of their life; some more frequently, some less. Consumers would certainly demand that for every hard earned dollar spent on healthcare, they are getting the best quality goods and services. In order to have this comparison, it is vital that the bills are itemized. It is very encouraging that the Ministry of Health has recently amended the PHMC guideline to request medical and dental clinics to itemize their charges, and to print out prescription to allow patients the freedom to buy drugs from anywhere that offers them better deal and services.
10. The press and media have been playing a very important role in reporting the various issues on drug pricing, price differentials in neighbouring countries, quality, drug abuse, ethics of various healthcare professionals etc. It is a very noble cause for any civil society and we will continue to support and facilitate their task in bringing to the Singapore public more inquisitive, yet unbiased reporting and news.
11. Lastly, on behalf of the Pharmaceutical Society of Singapore, I would like to thank our guest of honour, Madam Halimah Yacob for taking time off to grace this occasion. Selamat Hari Raya to you and your family.
12. A special thanks to all our invited guests, our speakers, friends and colleagues from near and far, our sponsors and the organizing committee headed by Ms Lim Ching Hui.
13. I wish you all a fruitful meeting and enjoyable days ahead at the 19th Singapore Pharmacy Congress.
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Ng Cheng Tiang
President, PSS at the Opening Ceremony of the 19th Singapore Pharmacy Congress in the Grand Copthorne Waterfront Hotel, 19-Oct-2007
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