Pharmacy group sees flaws in proposed law

Malaysian Pharmaceutical Society says it wants to protect patients' health and their consumer rights.

KUALA LUMPUR: The Malaysian Pharmaceutical Society (MPS) has pointed to alleged flaws in the proposed Pharmacy Bill that it says will weaken the protection of patients’ health and their rights as consumers.

Speaking to FMT, MPS president Amrahi Buang said the society disagreed with the Malaysian Medical Association as well as doctors complaining about errant pharmacists that the bill in its current form promotes the separation of roles between doctors and pharmacists.

“The big problem with the Pharmacy Bill is that it is supposed to address the issue of separation, but it doesn’t,” he said. “Rather than promote a separation of roles, it appears to benefit private medical practices at the expense of consumers.”

According to Amrahi, the bill is flawed for the following reasons:

1. It doesn’t make it mandatory for doctors to issue prescriptions to their patients.
2. It doesn’t make it mandatory for a diagnosis or indication to be written on approved prescription paper.
3. It allows pharmacy assistants to work for non-pharmacists.
4. It allows doctors to prepare personalised medications, a practice known in the trade as “compounding”.
5. It allows doctors to dispense psychotropic drugs.

Amrahi said it should be mandatory for doctors to issue prescriptions instead of dispensing drugs because their knowledge of pharmacology often fell short of what pharmacists would know.

“When we look at a prescription we look at the overall picture, the effects of the drugs, the dosages and so on. If we don’t find them suitable, we will alert the doctor. Nurses in clinics can’t do this because they aren’t trained for it.”

Furthermore, he said, patients wouldn’t know if they were paying fair prices for drugs unless they had prescriptions.

Referring to the necessity for the prescription paper, Amrahi said this would enable pharmacists to do their job properly. “For us to do our job as best we can, we need to know why a certain medication is prescribed.”

As to why he thought it was wrong to allow pharmacy assistants to work outside pharmacies, he said there would be no separation of roles if they were allowed to work in medical clinics.

“The use of pharmacy assistants may seem an improvement over nurses, but pharmacy assistants can’t replace pharmacists, just as a nurse isn’t a doctor.”

Currently, holders of a diploma in pharmacy can work as pharmacy assistants, but only under a pharmacist.

Referring to the process of compounding, Amrahi said it would be dangerous to allow doctors to do it because it required knowledge that went deeper than their understanding of pharmacology.

“As an example, say you need a syrup version of a certain medicine, but it isn’t available. That’s when compounding comes into play. Pharmacists will find a capsule version, break it down and turn it into a syrup with a specific formula.

“Compounding medicines go beyond what doctors learn in pharmacology. It has to be done right or the patient could suffer complications.”

Referring to psychotropic medicines, he warned that they could cause changes in perception, mood, consciousness or behaviour.

“These are very dangerous medicines and can be abused. This is why we are firm that they should only be dispensed by pharmacists. But the bill seeks to allow doctors to dispense psychotropics, though there is no logical reason to do so.”

Amrahi acknowledged that any law could be abused and there would be rogues among pharmacists as well as doctors, but he said the proposed law would improve measures to protect consumers if the flaws in the bill were addressed. “People will have greater access to information and access to treatment and medication. They will have more choices and will be in a position to make more informed decisions.”

He added that MPS would not protect pharmacies flouting the rules.

The proposed bill has been been talked about for years, but has yet to be finalised.

In 2015, Health Minister S Subramaniam was reported to have said the government had yet to finalise a proposal on the separation of the roles of clinics and pharmacies and was in the midst of dialogues with stakeholders. -FMT