Boo Su-Lyn | CodeBlue

The Pharmaceutical Association of Malaysia tells the government that just changing medicines for IJN, from originator to generics, won’t solve cost management problems. “It may even backfire” with a higher disease and cost burden if patients deteriorate.

KUALA LUMPUR, Nov 5 — Substituting innovator medicines with generics for public patients at the National Heart Institute (IJN) will not reduce the government’s cost burden, says the pharmaceutical industry.

The Pharmaceutical Association of Malaysia (PhAMA) – which mainly represents pharmaceutical multinational companies in the country – said it plans to seek an engagement with IJN to get more clarity on the government-mandated switch to generic drugs for the top cardiac centre.

“Medical treatment is complex and cannot be taken as a simple direct transaction,” PhAMA executive director Chan Li Jin told CodeBlue.

“Just changing medicines will not solve cost management for IJN. It may even backfire if the patient’s condition deteriorates and needs even more treatment and/or extended hospitalisation, which increases the cost and burden of disease even more.”

CodeBlue reported a directive from the Ministry of Health (MOH) and the Ministry of Finance (MOF) last month for IJN – which is owned by the Minister of Finance Incorporated (MOF Inc.) – to switch government patients from originator drugs to generic versions. Public patients comprise nearly 85 per cent of IJN’s patient load.

Putrajaya made the major policy decision after Prime Minister Anwar Ibrahim announced, during the tabling of Budget 2025, that pensioners would be allowed to continue their treatment at IJN. The MOH pays for the care of pensioners, civil servants, and underprivileged patients at IJN.

Despite stagnating patient visits and declining patient numbers of government patients at IJN over the past several years, the MOH’s payments to Institut Jantung Negara Sdn Bhd (IJNSB) jumped 68 per cent from RM361.8 million in 2013 to RM606.5 million in 2023.

CodeBlue reported a 2023 analysis on 10 drugs, all innovators, with the highest usage and claims charged by IJNSB to the MOH that showed prices ranging between 42 per cent and 4,323 per cent more expensive than the ministry’s procurement. These include common statins that are used to lower cholesterol.

With a mandated switch to generics, IJN is staring at a loss of at least RM100 million; multiple drug makers supplying the country’s top cardiovascular and thoracic care hospital are also bracing for losses extending to millions of ringgit annually.

The Galen Centre for Health and Social Policy and the Malaysian Medical Association (MMA) have said that not all innovator therapies have biosimilar or generic equivalents.