Dispensing Separation

Introduction

Dispensing separation is a critical policy that separates the roles of prescribing to physicians and dispensing to pharmacists.

  • Under this policy, community pharmacists can act as a safety net, identifying and preventing medication errors and interactions, ultimately leading to improved healthcare outcomes.


History

In Malaysia, the Poisons Act 1952 (and its subsequent 1989 amendment) granted dispensing rights to both doctors and pharmacists due to a historical shortage of pharmacists following the country's independence in 1957.

  • Over the following decades, the number of community pharmacists has grown significantly.
  • However, the limited opportunity for dispensing prescription medicines has led many community pharmacies to diversify into supplying health supplements and personal care products.

Currently, dispensing separation is implemented in government healthcare facilities and private hospitals, but not in private clinics.



The Importance

Dispensing is defined as the provision of medicine which involves

  • Verifying prescription validity
  • Checking dosages and potential drug interactions
  • Counselling patients on proper medication use

This process helps reduce medication errors and optimize patient safety.

Dispensing separation removes potential conflicts of interest by eliminating incentives for overprescribing or promoting specific products based on financial gain.

  • This promotes rational drug use based on clinical guidelines.



Arguments Against Separation

Some doctors argue that combined prescribing and dispensing under one healthcare professional allows for a more holistic approach to patient care, taking into account their individual needs and complete medical history when making medication decisions.

  • For some patients, especially those who are sick, travelling to a separate pharmacy is inconvenient.
  • Concerns also exist about limited pharmacy access in rural areas.

Due to low consultation fees, many private practice doctors rely on income from dispensing medication and dispensing separation could potentially affect their income and financial sustainability.

  • While medication prices might decrease due to bulk purchases by pharmacies, consultation fees could rise to sustain the clinic operating cost, as observed in other countries.



Summary

Dispensing separation in Malaysia remains a complex and debated topic, with ongoing discussions about its potential benefits, feasibility and impact on different stakeholders.

  • Finding a balanced solution that prioritizes patient safety, convenience, and affordability while addressing the concerns of all stakeholders is crucial for improving healthcare outcomes in Malaysia.



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