Probe procurement of medical supplies fully

WITH regards to the ongoing issues concerning the procurement of medicines by government health institutions, several parties including the Malaysian Medical Association have proposed the establishment of an independent body to investigate whether public funds have been spent as efficiently and as effectively as possible for this purpose.

However, any investigation into the matter should keep in mind the following points.

Firstly, any investigation into the procurement process should include in its scope not only the Health Ministry but also the Finance and International Trade and Industry ministries.

This is because, while the Health Ministry is the end user of the medicines procured, many of the rules (if not all) that dictate how procurement is conducted, what prices are being paid for medicines, and which agents are eligible to participate in the tender process involve these other ministries. Thus, the investigative body must be able to conduct an overarching review of the policies and procedures set by all the ministries and departments involved.

Secondly, the objective of any investigation should not be limited to examining the allegations of corruption in the procurement process.

While it is important to find out if laws have been broken, it is also necessary to determine if the Government is paying excessively high prices for medicines as a result of obsolete policies or disadvantageous agreements and con- tracts even in the absence of corruption. It needs to be emphasised that it is entirely possible for leakages and the wastage of public funds to occur in a completely legal manner, hence a full review of how the existing policies and procedures impact the prices paid for medicines is required.

Thirdly, any investigation into the subject of monopoly has to consider that in the case of medicines, one does not need to control 100% of the drug supply to have a monopoly.

Many medicines are unique products that are not interchangeable or do not have equivalent substitutes, and therefore having the exclusive right to supply certain medicines constitutes having a monopoly on the said medicines.

If you add into the mix the efforts of pharmaceutical companies to use the patent system to block the production of generic competitor medicines, it becomes apparent that monopolies are being (or have been) established, with the resultant negative effects being borne by the public purse.

The Health Minister, by all accounts, is sincere in his desire to improve our healthcare system.

Tackling the issue of medicine procurement and the pricing of medicines, however, will require a comprehensive and coordinated effort by the Government as a whole.

We look forward to hearing progress on this matter. MARK CHEONG WING LOONG School of Pharmacy Monash University Malaysia