Proposal to Promote Use of Generic Drugs in Public Healthcare Institutions

Mr Speaker, the Ministry of Health (MOH) works with doctors and pharmacists from public healthcare institutions (PHIs) to encourage the usage of suitable generic drugs. In 2017, to better guide institutions and doctors in the use of generic drugs, we introduced a basket of clinically and cost-effective generic drugs which can replace the more expensive branded equivalents.

MOH and the Health Sciences Authority (HSA) monitor new generic drugs that enter the local market and add them to the basket on a regular basis.

MOH and PHIs have also implemented other measures to drive use of generic drugs. These include automatic substitution at the point of drug ordering, requiring doctors to provide explanations on the usage of more expensive branded drugs where generics are available and monitor its usage.

The utilisation of the generic drugs in the basket has risen over the years. By volume, the usage of the generic drugs in the basket has increased from 87% in 2013 to 99% in 2017.

Mr Speaker, Sir, I thank the Senior Minister of State for his reply. Just a few supplementary questions. Firstly, are there plans from the Government to monitor the extent to which, across the board, branded versus generic drugs are prescribed in healthcare institutions because, as I understand it, the cost differences can be really tremendous? For one active ingredient that I just checked at retail, the cost difference is actually a factor of seven times. So, it can make a huge impact on curbing a spiraling healthcare cost. That is the first question.

Secondly, at the retail level, of course, given the trend that many people are self-medicating, anecdotally, it has been observed that at our pharmacies, generic versions of drugs sometimes cannot be found so easily, they are not displayed so prominently or sometimes they are not available at all, compared to pharmacies in countries like the United States (US), for example, where generic versions are prominently displayed with huge cost advantages. Is that something that the Government is looking into?

Thirdly, again, anecdotally, there are cases that one hears about where in the private healthcare space, generic versions of drugs are sometimes prescribed at the same price as the branded version without the patient really being aware of it. Is this also something that the Government is looking at?

Lastly, is there a resource that patients can go to to access typical retail prices of branded versus generic drugs for common cases? Is this something that is available and, if not, can that be looked into as well?

I would like to thank Mr Leon Perera for those supplementary questions. In the PHIs, we do have a committee called the National Pharmacy and Therapeutics Committee that looks into the various kinds of drugs that can be included into this basket of generic drugs. We review them very regularly and these drugs are included because they have a high impact on the costs in terms of drug prescription. Basically, these drugs are usually assessed to have high spending and high utilisation in the PHIs.

With regard to the generic options at retail pharmacies, I think this will be up to the business model of the pharmacy in deciding whether it is better to bring in the generic options or the branded options. However, I have come across many private pharmacies that do carry generic options for patients' purchase.

For like-minded practitioners, such as private general practitioners or even intermediate long-term care providers who are mindful of drug cost, we are also trying to encourage them to have some form of collaboration in terms of group purchasing or group procurement. This will, hopefully, help reduce the cost of drugs in the private sector.

The Member also mentioned about whether we could encourage private healthcare providers, such as private hospitals or private clinics, to use more generic options, and also the amount of generic drugs versus branded drugs that are being charged. This is a business decision by the private hospitals and practitioners. As they have different operational expenses and considerations, it is difficult for MOH to dictate exactly how much or what kind of drugs they prescribe to their patients.

I thank the Senior Minister of State for his very detailed answers. There was one question I asked: is there an online resource available for patients to check the price of generic versus clinically equivalent branded drugs, to educate patients so that they can perhaps demand for generic versions to lower the cost that they will need to bear? And if such online resources are not available, is this something the Government is looking into?

I thank the Member for the suggestion. I am not aware whether there is an online resource for that purpose. But I can check and update the Member.