Leong Sze Hian/
I refer to Mdm Choi Lim Siew’s letter to the Health Minister regarding her problem of cancer treatment and drugs that are non-subsidised, which was copied to, and published on April 6 on The Online Citizen.
In this connection, I would like to refer to the Committee of Supply for the Health Ministry’s debate in Parliament.
The Health Minister said in reply (“No issues making drug list public but…”, Today, Mar 5) to NCMP Sylvia Lim’s question, that he is open to the idea of putting Singapore’s Standard Drug List – comprising drugs deemed cost-effective and essential to healthcare provision here and thus subsidised – online for greater transparency.
However, he wanted to avoid lobbing by pharmaceutical companies for their drugs to be included, as they have subjected him to lobbying very often, such that every time a top CEO flies through Singapore, they usually don’t talk about other things, other than “please put my new drug onto your list”.
Why “drugs’list” is secret?
I would like to suggest that the list of non-subsidised drugs be published instead, so that patients will know and be able to make more informed decisions.
In this connection, a recent Ministry of Health reply to media queries which is on its web site, said that more patients are now ‘internet savvy’ and come armed with printouts to request for drugs which may be non-subsidised.
“Hospital acquired infection” also non-subsidised?
If a patient acquires an infection whilst in hospital, and the only treatment is non-subsidised drugs, with no subsidised drug alternative, is it fair for the patient to be burdened with the high cost of the required non-subsidised drugs, since it was a “hospital acquired infection”?
Often, doctors and hospitals prescribe in accordance with global treatment guildlines, non-subsidised drugs.
In such circumstances, is it fair for C Class patients like Mdm Choi Lim Siew to pay the much higher cost?
For the above two situations, shouldn’t they be ”drugs deemed essential to healthcare provision here”?
What has drug CEOs lobbying got to do with publishing the drugs’ list?
I also do not understand how publishing the drugs’ list, will impact the drug company CEOs who try to lobby the Minister.
Because, with or without the list, wouldn’t CEOs know that their drugs are non-subsidised, and thus lobby the Minister anyway?
By the way, how many times in a year is the Minister visited by CEOs, and how many try to lobby him?
Finally, is it not part and parcel of the Minister’s job to expect to be lobbied by CEOs?
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Khaw Boon Wan basically shot himself in the foot by asserting that many S’poreans are now asking for non-subsidised drugs, thus leading to higher hospital bills. But he is now saying that the list of subsidised drugs is a top state secret. So my question for Khaw is how in the hell would S’poreans know that they are choosing non-subsidised when the list of subsidised drugs are not make known???!!!
Of course drug companies will always try to push their drugs. There are different channels of promotion. On the end of prescribers, all MNC pharma companies have to observe a strict code of ethics for responsible marketing tactics. (Refer to http://www.sapi.org.sg).
At the highest level, it can be expected that CEOs “fly in” to lobby for their drugs. But surely we can expect our multi-million-dollar MIW ministers not to cave in to the industry’s lobbying if it is against the interests of Singapreans. After all, that is part of the basis why these ministers demanded out-of-the-world remuneration for themselves.
To cite “lobbying” as an excuse not to list standard drugs, when lobbying is ubiquitous throughout the world, does not make any sense at all.
leong. you have my support.
How come there is so many secrets kept by our govt ? We have financial secret of Temasek and GIC billion $ losses, now we have medical secret of high cost non-subsidised drugs. Seems like every time they have something to hide or cannot give us a honest or satisfactory answer – the issue become highly sensitive and classify as state secret.
Even I decide who to meet & not to meet.
Doesn’t he have a PA?
Our consumer laws, standard of care & duty of care is at an all time low in Singapore.
If we do not question these and improve the lives of all of us, then its just going to be another worst 5 more years.
We are going to go from here and come
back in 2016 to face the same questions again.
georgia tong
you missed out the cost to build HDB flat secret.
Being ‘visited’ by CEOs is such a trivial matter compared to having drugs that can save lives, everyday.
Pay me million$ and I’ll gladly face the problem of ‘visiting’ CEOs for you. :)
when the 1st batch of injected insulins hit our shore..it was market @ $15/bottle
the same brand in other countries is sold @ $11 average..when a new brand was introduced..the same insulin/same size hit up to $19/bottle..
don’t seek nor inquiry to that mlaysianborn minister..he also don’t know why..he just said you buy or die
MY PROBLEM mey?
“Finally, is it not part and parcel of the Minister’s job to expect to be lobbied by CEOs?”
PAP ministers like the million-dollar salary but hate to work for it
PAP means more years of hardship
PAP ministers like the million-dollar salary but hate to work for it
…..
indeed well PROVEN..ah tin the bimbo youngest pap canbeDEAD already ASSUMED she gonna be an MP without workin @ all
that she profersis..she had NO time to brin her kopishop owners parents to the irresorts..everybody knew the irresorts is beyon a normal workin family xpenses
ahTIN xcuses was not because she cannot afford it..she hav NO time for them @ all
and why on earth did sahe get hitched @ an early age…just because her hubby is the speakpeople for our royale highness perhaps? got alot of weekends to rub shoulders2shoulders with the elitists…
if she is as good as annabel cheong the whole cabinets ministers she can bed them all in 1 night…
WITHOUT A DOUBT………………
The same medicine you buy in Johor is probably a few times less. And why? Malaysia is not a first world country and how come they can do this?
In Singapore, everything is about making $$$.
At hospital, you think prices are high. Wait till they push you to private nursing homes. The same drugs or injections will be multiplied like few hundred times. Same injection+medication+bed will sometimes cost you $400 a day.
I think the hospitals are not subsidizing it because they know they can make a lot of $$$ and they refuse to publish the list. If you publish, you can walk into Malaysia and then check. And to your astonishment, you will go online and air it.
Khaw or MBT are the same breed, midgets with small eyes, just want to please their masters and balloon their coffers.
the trouble is, there is no “level playing field”.
many so called, investments, come in on FREE RIDE, due to the many subsidies the gov hands out to these freeloaders.
schemes, like EDB,productivity incentives, AIS, rent subsidies (JTC), land subsidies(URA) and many more from the MANY gov machinery, given out to ATTRACT such investments,are at the expense of locals(money given to create jobs but then the jobs and high wages goes to someone else).
how in the world would another company somewhere else be able to compete with such companies here, given the current low tax rate, plus tax free incentives for pioneering or regional hq and other so called wonderful names.
they certainly have it all, in job credits during lean years, subsidies in all kinds, even electricity and water, for wafer plants.
BIT DO LOCALS GET ANYTHING BACK,
HELL, MORE LIKELY, HIGHER TAXES, INFLATION IN FOOD, HOUSING, TRANSPORT, IN ALL THINGS
AND LOWER WAGES……….
WHAT A GREAT GOV LOCALS HAVE……….
MORE THIEVES AND ROBBERS AND A MAGIC SHOW OF NUMBERS
I have diabetes, high blood pressure and high cholestrol. It is a fact that most drugs are cheaper in Malaysia without subsidy than subsidized drugs in Singapore. One example in Zorcor and Lipitor.
The reason expensive drugs are hardly subsidised because this gahment knows that if you have some serious sickness, you are screwed, you no longer have any economical value, you are taking money from the CPF Medisave.
This gahment have a strong disdain for any withdrawal of money in any form from the CPF. They rather blow $300 million bucks on kiddie games or gamble away $200billion dollars in stupid investments.
I fail to see why there should be a distinction between “standard” (and thus subsidised) and “non-standard” drugs.
What is considered “standard” using whatever yardstick in the past is probably superseded by all the technological advances that has taken place.
Newer cancer drugs like Gefitinib are considered standard 1st line treatment for metastatic lung adenocarcinoma with the appropriate mutation. Same for newer techniques like Intensity Modulated Radiotherapy for Nasopharyngeal Cancer. And in a few years’ time, particle therapy like Boron Neutron Capture Therapy might become standard therapies too.
If I have a headache and panadol does not work and I am allergic to ponstan, I should be able to get stronger analgesia, without having to worry about whether the stronger medication is “non-standard” and thus not within my bugget.
If Singapore’s greatest resource is her people, then it stands to reason that Singaporeans should be given the best health care services without having the need to worry about affordability, particularly in the areas of cancers which are neither preventable or screenable.
Looks like every time a million dollar minister in Singapore cannot answer a question posed to him, it is because the facts are a “state secret”. Is there a cover up involved?
In this case, is it because the drug company CEOs are bribing or paying off our minister to put their drugs on the secret list?
My memory is starting to fade, but I recall the last time some statistics were declared a secret by one of our ministers when questioned in parliament, it was to do with the number of unemployed Singaporeans compared to PRs and other residents. We all know that the reason for this, was that the reply would be too embarrassing for the PAP government.
I agree with Mr Leong here. Our Health Ministry is sadly so out of touch with the populace that needed help. Any clarification on subsidised or Non subsidised drugs will be very helpful to the General Public. As for being lobbied by CEOs of drug companies, it comes with the job Health Minister. Is it possible you have no wish to do your job well?
I think we’re not getting the full story here. First it’s likely that drug companies have some hold on the Singapore government. The drugs are probably part of the deal in which they set up manufacturing plants here and give Singaporeans jobs. In return, they ask for a higher price for drugs sold to Singaporeans.
And the drug list I think is not meant to be kept secret from the citizens. It is also meant to be kept secret from rival companies because if every company knows what rival’s drugs are being subsidised then the whole process would become a big circus.
I’m just wondering why Singaporeans are so ready to talk about the government’s role in all this, but the pharma MNCs get away scot free, nobody ever realises they are the real bad guys, nobody ever wants to find out how to squeeze their balls.
And there are better things to do about complaining about secrets in this article. We should just set up a website and encourage people to fill in what medicine they’ve been prescribed, what’s the ailment treated, when they bought it, how much they paid for it, whether it was subsidised. And we aggregate this, then everybody will have a database, and nobody will complain about this being a secret anymore.
Many of the drugs sold in the public hospitals and polyclinics are purchased collectively by way of tenders and quotations. The purpose of such collective purchase is to ensure lower drug prices through competitive bids for large volume.
In the past, the results of these tenders and quotations are accessible by the public. Information on which company was awarded the contract, at what price and volume, as well as the quoted prices of all other bidding companies could be known.
However, this transparency was removed several years ago when the bid prices are no longer disclosed. It is impossible now to determine to what extent high drug prices are due to high bid prices as companies no longer have a reference from the previous bid, or the margin markup by pharmacies.
It is therefore premature to ascribe high drug prices to pharmaceutical companies without knowing the actual cost of drugs sold and the margin markup to the consumer.