Kuala Lumpur, 11 October 2024 — The Galen Centre for Health & Social Policy calls upon the Madani Government to make reforms and increase investments in four critical areas: healthcare financing; dialysis care; dermatology, and access to innovative medicines.

“We know what changes are needed, how much money is available, and potential solutions to address issues such as recruitment and retention of healthcare workers, modernisation of key medical infrastructure, and strengthening health security,” said Azrul Mohd Khalib, Chief Executive Officer of the Galen Centre for Health and Social Policy.

Healthcare financing

“The Government should remove the RM 1 and RM 5 charges for outpatient and specialist care respectively in Ministry of Health (MOH) facilities. People should not need to pay anything at the point of accessing care. These charges also keep alive the fiction that the cost of healthcare in Malaysia is cheaper in government facilities, and mislead the public. Removing these charges will open the way to meaningful discussion and serious consideration of future reforms in healthcare financing,” Azrul emphasised.

“We need to not only identify new and sustainable funding for health, but also ensure that aged care will be properly supported. Malaysia is a few years away from becoming an aged nation, but some parts of the country are already aged states such as Penang, Perak and Melaka.”

“We recommend introducing national health and social insurance. The pooling of funds will go towards investing in two separate areas: health and aged care. It will complement the existing annual budgetary allocation, and not replace it.”

Dialysis care

“Each year, more than 10,000 people are newly diagnosed with kidney failure and needing dialysis, and this annual number is steadily increasing. As the number of people with diabetes increases, MOH has projected that more than 106,000 Malaysians could be on dialysis by 2040. Most will likely be on haemodialysis. However, automated peritoneal dialysis (APD) should be prioritised and supported, both in the public and private sector.”

“Patients on PD have the potential to live longer, healthier, with more mobility, and without the need for major medical equipment. They are more productive and have a better quality of life. Having just the government to prioritise peritoneal dialysis is insufficient,” Azrul pointed out.

“We recommend that the Government introduce tax rebates for private dialysis centres to switch their patients to peritoneal dialysis as a form of financial incentive and encouragement, and to support the National PD First policy.”

We recommend introducing national health and social insurance. The pooling of funds will go towards investing in two separate areas: health and aged care.

Dermatology

“Dermatology is under prioritized and underfunded. Dermatology patients in advanced stages of their conditions such as for generalised pustular psoriasis and atopic dermatitis, are forced to resort to seeking innovative treatment with out-of-pocket payments, increasing the likelihood of catastrophic expenditure,” Azrul highlighted.

“Investing in immunotherapy and biologics offers significant long-term cost benefits and improved health outcomes.  Although such medication and treatments may have higher upfront costs compared to traditional therapies, they are often more effective at controlling symptoms, preventing further disease progression, and have an overall favorable safety profile. This leads to fewer hospitalizations, reduced need for ongoing treatments, and less time lost to disability. They have been proven to lower overall healthcare expenditure.”

“We recommend that the Government increase the medicines allocation for the dermatology services. Many dermatology patients depend on this essential service to improve their quality of life, address stigma and discrimination, and reduce pain and suffering due to their condition.”

Access to innovative medicines

“The annual drug budgets in public hospitals (under both Ministry of Health and Ministry of Higher Education) struggle to sufficiently accommodate innovative therapies despite their increasingly critical role in treatment, improve health outcomes, and save lives. Providing efficacious and safe immunotherapy or biologic agents to patients, is a challenge under existing budgetary limitations and priorities,” Azrul pointed out.

“We recommend that the Government allocate and earmark 5% of annual revenue from excise duties imposed on the sale of tobacco, vape, e-cigarettes, and alcohol products (estimated to be more than RM 5.5 billion per annum) to provide funding of an estimated RM 290 million annually for the procurement of innovative medicines. This will be a focused,  sustainable and targeted fund to ensure the availability of lifesaving therapies for those who need it. This move will save lives and prolong life.”