Debated in Parliament on 15 Jan 2019.
Ms Irene Quay Siew Ching asked the Minister for Health (a) what is the percentage of standard versus non-standard drugs prescribed for MediFund assistance patients in comparison to non-MediFund assistance patients in restructured hospitals; and (b) what is the governance in place to ensure appropriate prescribing of non-standard drugs for MediFund assistance patients.
Mr Speaker, doctors in our public healthcare institutions typically prescribe patients with standard drugs. Doctors may sometimes prescribe non-standard drugs in specific instances, for example, if the patient does not respond to treatment with standard drugs or cannot tolerate the effects of standard drugs commonly used for his or her condition.
We currently do not have ready data on the percentage of non-standard drugs prescribed for patients on MediFund assistance versus those who are not. Overall, however, 85% of drugs prescribed in public healthcare institutions are standard drugs. This has been consistent over the last five years. Available data from our public hospitals do not suggest that there is a systematic difference in the percentage of non-standard drugs prescribed amongst subsidised patients.
To guide appropriate utilisation of drugs, the Ministry of Health's (MOH's) Agency for Care Effectiveness (ACE) publishes guidelines on the appropriate use of selected standard drugs. To encourage the use of standard drugs, they are included on a Standard Drug List (SDL) as well as a Medication Assistance Fund (MAF) list where subsidies are provided and patients receiving the drug should meet predefined clinical criteria. Where clinically appropriate, drugs that are not on the lists may also be accorded financial assistance on a case-by-case basis. Internal hospital committees are charged to ensure that drugs funded under MAF follow the guidance. In addition, MediFund provides additional subsidies to those who are facing financial difficulties, including for non-standard drugs, to ensure that they are affordable.
MOH tracks drug utilisation in Public Healthcare Institutions (PHIs) to monitor compliance to ACE Guidelines. Each public healthcare institution also has governance in place to ensure appropriate drug utilisation. For example, Pharmacy and Therapeutic Committees evaluate drugs for inclusion in their hospital drug formulary and guide doctors on the drugs to use in the course of treating their patients.
MOH shares the Member's concern that patients should be prescribed the drugs that are appropriate for them. MOH will continue to remind our healthcare institutions to do so and also strengthen our governance processes where necessary.
PAPERCUTS