KUALA LUMPUR, Aug 18 ― Retired government servants will now no longer be reimbursed if they buy brand-name medications unavailable at public hospitals, the Ministry of Health (MOH) said.
Instead, they will receive generic medicines, like other patients, Health deputy director-general Datuk Dr S. Jeyaindran confirmed.
He said there should not be problems of medicine availability at government hospitals because the MOH has increased drug quotas by taking some 700,000 retired civil servants into account.
“The policy is to supply what is given to all other patients treated at MOH. Even serving senior civil servants are given generics,” Dr Jeyaindran told Malay Mail Online.
He acknowledged that some patients had their prescriptions and medical claims getting stuck between March and early this month when the government stopped the services of OratisRX Sdn Bhd, which was contracted by the Public Service Department (PSD) to provide pensioners with free medicine and medical equipment unavailable at public facilities.
But Dr Jeyaindran said the standard operating procedure has been fine-tuned and put into place in the last six weeks, with PSD transferring funds to MOH for pensioners’ health care and the Retirement Fund (Inc) (KWAP) handling all dialysis and dialysis-related claims.
“Medication money has been sent to each hospital. Money for implants is managed by MOH centrally,” he said.
Malay Mail Online understands that OratisRX used to supply some original medicines for pensioners that would be borne by PSD despite MOH’s “generic first” policy, such as the popular blood thinner Plavix (brand name for clopidogrel) usually prescribed for people who have suffered a heart attack or stroke. According to Dr Jeyaindran, the generic is 17.5 times cheaper than Plavix.
“For the Pensions Department, instead of paying RM7, [now they are] only paying 40 sen,” he said, referring to the blood thinner generic that will be supplied additionally to public hospitals for pensioners.
Deputy Defence Minister Datuk Seri Mohd Johari Barum said last March that pensioners who had enjoyed the convenience of collecting their free medical supplies from private pharmacies, clinics or hospitals would now return to the “manual way”, namely pay first and claim from PSD later.
A general practitioner ― whose 74-year-old mother, a pensioner, suffers from hypertension, diabetes, cataract and is deaf in one ear ― said pensioners had to wait between three and six months after the purchase of original medications for PSD to reimburse their claims.
“The process has been made difficult, so people opt for the cheaper generics,” the doctor, who requested anonymity to protect his mother’s identity, told Malay Mail Online yesterday.
But now, pensioners will only be able to get generics at public hospitals like everyone else, albeit for free. Government hospitals will buy certain drugs for them if necessary and pensioners can collect it at a later time, as none of the medications on OratisRX’s list back then were emergency-related, according to Dr Jeyaindran.
“If patients are treated in government or university hospitals, they should have access to the same drug.
“If doctors want to use a drug outside the Blue Book, they must justify why the patients need it,” he added, referring to the MOH’s drug formulary.
According to a June 30 circular by MOH, MOH has taken over management of medical treatment of federal government retirees and pensioned military veterans, together with the Ministry of Higher Education and the Defence Ministry, effective June 1.
The circular stated that approval from the Health director-general was required to get drugs outside the MOH formulary based on these guidelines: drugs in the formulary were ineffective in treating the patient, the patient suffered adverse effects from drugs in the formulary, and the application was not intended to continue medical treatment that had been started at a private hospital or a hospital from another ministry.