Most patients seem to prefer clinic-dispensed medicine

The pros and cons of in-clinic dispensation of medicines as compared with prescriptions filled by pharmacies have been studied comprehensively (Two issues contributing to over-servicing in healthcare, by Mr Li Ze Zong; April 4).

Clinic-dispensed medicine increases patient convenience and compliance, and makes available cheaper generic medications, among other advantages.

But there is always the danger of over-prescription by doctors because of the profit motive.

Pharmacies, when used, are often touted as a second layer of checks for allergies and cross-reactions between medicines.

They may not necessarily be cheaper, and indeed are often more expensive as they stock mainly branded medicines.

Errors in the dispensation of medicines by pharmacies are as common as in clinics.

Laws to separate prescription and dispensation duties will simply make doctors upgrade their in-clinic dispensing facility to one which satisfies health statutes, including the employment of bona fide qualified pharmacists, which will surely increase costs.

Research into countries that separate prescription and dispensing functions does not find them having savedmuch in health costs, if at all.

In fact, a 2013 study done in Switzerland, a country with somewhat similar living and health costs as Singapore, proved that physicians dispensing medication resulted in lower pharmaceutical costs per patient.

Locally, patients can always opt to have their prescriptions filled in a third-party pharmacy. General practitioners will attest that only a negligible number of patients would want to do so.

Where patients can claim medicine costs from the Community Health Assist Scheme, Pioneer Generation Package or Medisave, an all-in-one medical facility tremendously cuts down on administrative complexities.

Mistrust of doctors opens up a Pandora's box. They might as well be stopped from doing in-house blood tests, electrocardiography and taking X-rays since these can also be abused or misconstrued to be profit-margin padders.

Yik Keng Yeong (Dr)

A version of this article appeared in the print edition of The Straits Times on April 07, 2018, with the headline 'Most patients seem to prefer clinic-dispensed medicine'. Print Edition | Subscribe