Rising healthcare cost and expenditure are critical issues that impact both consumers and our overall healthcare system.
Indeed, more needs to be done to ensure a financially sustainable and robust healthcare model in Singapore (Better if pharmacists dispense medicines instead of doctors, by Mr Jeremy Chan Lin En, March 22; Two issues contributing to over-servicing in healthcare, by Mr Li Ze Zong, April 4; and Most patients seem to prefer clinic-dispensed medicine, by Dr Yik Keng Yeong, April 7).
Any policy or recommendation that is made should ultimately benefit patients and address issues of affordability, accessibility, safety and patient outcomes.
In Singapore's public sector (hospitals and polyclinics), the separation of prescribing and dispensing medicines is well-established.
Benefits of this system include rational drug use to ensure appropriateness while avoiding conflicts of interest, lower costs with generic medicines, and pharmacists providing advice on the proper use of medicines.
General practitioners play an important role in the private primary care sector, where patients enjoy convenience in obtaining their medicines directly from the clinics.
Patients have a choice to fill their prescriptions from community pharmacies, which carry both branded and generic medicines.
Drug prices at pharmacies for common chronic conditions such as diabetes, hypertension and high cholesterol are available on the Pharmaceutical Society of Singapore website.
Pharmacists serve as another layer of safeguard by ensuring the appropriate use of medicines at the right dosage regimen, counterchecking drug allergies and drug-drug/food interactions, and providing counselling on the proper use of medicines to ensure adherence.
With every country's healthcare model being different, and healthcare cost confounded by many factors, it is challenging to draw conclusions on the impact of physician or pharmacist dispensing on total healthcare expenditure. The choice can be left to consumers.
Nevertheless, more can be done to facilitate these choices by encouraging employers to recognise purchases from pharmacies as valid for reimbursement and to facilitate the portability of subsidies to community pharmacies.
With the increasing burden of an ageing population and complexity in chronic disease management, we should focus on a collaborative model where various healthcare professionals come together, working in synergy to provide the best health outcome.
Irene Quay (Ms)
President, 112th Council
Pharmaceutical Society of Singapore