DRUG shortage remains a serious problem for most patients, and cancer patients are also reeling from the impact of the crisis, National Cancer Society Malaysia (NCSM) director Dr Murallitharan Munisamy said.

While there have been reports of shortages of antibiotics and over-the-counter drugs for fever, flu, cough and cold at medical facilities, he said cancer medicines are also on the low, especially at government healthcare centres.

Apart from lack of funds to procure the medicines, there are also other reasons that could have contributed to this, he said.

Among them, he said, is the weakening of the ringgit against the US dollar.

“Procurement of medicines for the government is always by tender,” he told The Malaysian Insight.

“Pharmaceutical companies would have tendered to the government at a certain price but because the tendered price and the price now may be different due to the fluctuation of ringgit to US dollar. So some companies could be at a loss here.

“Hence, pharmaceutical companies will resort to reasons like no stock, cannot bring in drugs and others, but actually they are waiting for the fluctuation to resolve.”

He said supply issues and the war between Russia and Ukraine are the other reasons for medicine shortages.

“We know that a lot of raw materials for medicines are from India and China. Both of these countries have supply shortages due to Covid-19 as there are lockdowns and other issues. So, it affects production, which, in turn, affects the amount of medicines being exported,” said Murallitharan.

“Also, a lot of disruption of the global supply chain is from the war (Russia-Ukraine), even though it doesn’t look like it.

“The supply disruption is not only in Malaysia but it’s a global issue.

“Because of this, even the medicines we have paid for is not coming or they are not coming in proper numbers, meaning the order is not being fully satisfied.”

Pandemic caused issues

Murallitharan said there were other issues that coupled with the Covid-19 pandemic, which he said had a direct impact on the current situation.

He said limits in allocations, job losses, increase in patients to government healthcare facilities are also reasons contributing to medicine shortages.

He claimed that the budget for cancer treatments was slashed in order to fund Covid-related management.

“We feel that because of Covid-19, a lot of money has been spent on communicable diseases,” he said.

“We know that hospitals are taking a hit, in terms of money being dispensed. So when there is a budget cut, it will always hit the non-communicable diseases such as cancer because cancer treatment is expensive.

“We know this is happening but don’t expect this to recover in the next one or two years.”

Murallitharan said the cancer medication shortage has worsened over the past couple of years caused by the loss of income of patients due to Covid-19.

He said those who were previously seeking consultation and medications at private hospitals have now turned to the government.

“The problem has worsened because there are too many patients seeking treatment at government hospitals as they have lost their jobs,” he said.

Murallitharan said his organisation now comes into the picture when patients cannot afford medications or are unable to get them from the public hospitals.

“When there is no medicine at public hospitals, patients have no choice but to buy them from private healthcare centres,” he said.

“So this is when we come into the picture, where we start supplying medicines at a much cheaper rate.

“By doing that, we can stretch the patients’ money a long way because private care is very expensive.”

He said pre-Covid-19, NCSM did not work much on patients’ assistance programmes unlike these days.

“The patients’ assistance programme is actually procurement of medication, which we then supply to patients without marking up the price,” he said.

“Hence, it becomes significantly cheaper, almost 70% cheaper than buying from the private sector.”

Cancer medicines are not subsidised by the government, thus forcing some patients to buy them at premium rates in pharmacies or private hospitals.

Fixing the issue

When asked what could fix the medicine shortage, Murallitharan said funding would be the common answer.

Although welcomed, he, however, said increasing funding would only be a short-term solution.

He said Malaysia has to think beyond rather than just having short-term fix to any situation.

Among his suggestions is the production of own medicines, which he claims Malaysia is still not good at.

“The world held us hostage for Covid-19 vaccines and this should have taught the government a very important lesson that we have to be self-sufficient,” he said.

“We have to start producing our own drugs. We are not very good at doing it.

“We are still stuck in the mentality of procuring medicines from abroad.

“The biggest buyer of drugs is the Health Ministry. If our country can produce its own medicines, then we can save a lot and don’t have to rely on others.”

Murallitharan also spoke about medicine wastage and how the government can look into having policies on reusing them.

He said a lot of medicines go to waste because there is no policy on reusing them or educating patients to return unused medicines.

“Our system is quite ill-equipped to deal with returning medicines and delving into recollecting and reusing medicines,” he said.

“Sometimes, when one of our patients passes away, the family will bring boxes of medicines. We could give these medicines to others who need them.

“But we can’t see this. We need to educate people on this and there must be a visible system for us to take the medicines and use them.

“I don’t think we have a policy where we can reuse medicines. We need to look at policies and ways to reuse medicines rather than wasting them.” – June 23, 2022.