LETTER | The Malaysian Medical Association calls on the government to resolve the long-standing private general practitioner (GP) fee schedule issue as well as implement measures to ensure responsible sale of prescription drugs at pharmacies and online before it implements medicine price display at private GP clinics.

The Malaysian Medical Association (MMA) urges the government to postpone the mandatory implementation of medicine price displays at private GP clinics, scheduled to take effect in 2025 until private GP consultation fees are reviewed and gazetted. We also call on the government to implement measures to ensure sale of prescription drugs at pharmacies and online are strictly regulated before it proceeds with its move.

While MMA supports transparency in healthcare pricing, enforcing this policy without addressing the long-standing issue of GP consultation fees - unchanged for over 30 years - will threaten the sustainability of private primary care services, endanger GP clinics, and push more patients toward already overcrowded public healthcare facilities. Furthermore, it needs to be noted that patients already have access to information like the price of services and drugs available to them at private clinics upon request.

For decades, private GP clinics have been the first point of access to healthcare for Malaysians, including the B40 and M40 communities. These clinics play a crucial role in providing accessible, quality care while reducing congestion at government hospitals.

However, due to a surge in contract doctors exiting government service to enter into private practice, Malaysia has seen an oversupply of GP clinics, with 4,000 new clinics opening in recent years, leading to intense competition and financial strain.

A 2017 MMA study found that 30 percent of clinics operate at a loss, 30 percent barely break even, 30 percent survive but do not grow, and only 10 percent are in good financial health.

With 60 percent of GP clinics under financial pressure, any additional regulatory burden without economic safeguards will force more clinics to shut down, ultimately impacting the public who rely on affordable and accessible GP services.

GPs do not operate like retail businesses; they provide comprehensive medical care under 54 acts and regulations. Unlike businesses which offer only one component of healthcare services, GPs deliver holistic patient care, including consultation, diagnosis, treatment, and follow-up. Medicine dispensing is not a separate service but an integral part of the regulated, patient-centered medical process.

The private GP consultation fees have not been reviewed for over 30 years, despite rising operational costs - rent, salaries, and regulatory compliance. Many clinics rely on cross-subsidisation from medicine dispensing revenue to keep services affordable. Implementing the price display policy without revising consultation fees will force clinics to either increase charges or reduce service quality.

If more private GP clinics close, patients will turn to government hospitals, leading to longer wait times and worsening congestion. This policy contradicts the government’s goal of strengthening primary healthcare services to ease the burden on public hospitals.

Additionally, with medicine price displays, there is a strong likelihood of consumers opting to purchase prescription drugs from pharmacies or via online shopping. We are deeply concerned about the lack of control over the widespread sale of prescription drugs without a doctor's prescription at pharmacies and online - an issue highlighted by MMA in the past.

All sales of prescription drugs whether at pharmacies or online should be strictly regulated with audits carried out by the Health Ministry to ensure responsible sale of medicines. The sale of prescription drugs with a doctor's prescription must be strictly enforced with proper records to document the sales.

MMA urges the government to delay implementing the medicine price display policy until the GP consultation fee schedule issue is resolved and a system is in place to strictly regulate the sale of prescription drugs at pharmacies and via the web.

We call on the government to reassess this policy in the interest of the people and ensure that the healthcare system remains fair, sustainable, and patient-centred.

DR KALWINDER SINGH KHAIRA is the Malaysian Medical Association president.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.