polyclinics pricing

last SG · 2006-03-13T16:42:01+00:00

charlize: you must be joking, please re-read his exchange with MP Tan CB.

charlize SG

You know the story about nkf and it's profits from selling "subsidized" medicine.

Nobody wants the same scenario to happen to the polyclinics. Laughing

claudetnt SG

for all you know it may be happening now!

oxford mushroom SG

If so, why then are some of these medicines sold in Malaysia, Thailand, Australia and UK cheaper than those at our polyclinics? I don't think the medicines at those private pharmacies are been subsidized!

Medicines may be cheaper in Malaysia and Thailand cos' the manufacture and retail costs are lower there, just as computers are so much cheaper to buy in Bangkok. I am living in the UK and I can assure you medicines are NOT cheaper here. I don't where you get the idea...you can get free medication under the NHS if you are eligible but if you buy it off the counter, the cost is atrocious.

I don't know about Australia though..

charlize SG

Here's an interesting article posted in another thread in Speaker's Corner on this issue. Laughing

http://www.sgforums.com/?action=thread_display&thread_id=181932

oxford mushroom SG

They are following certain guidelines laid out by expert committees on the way a disease should be managed. Ordering unnecessary tests does happen, but it is not to earn money, but to protect the doctor's backside. Without lab tests, doctors have to rely on their clinical skills and experience to make decisions. All the responsibility falls on them. Sometimes they make a bad decision and they can be sued. On the other hand, even if you make a bad call based on an erroneous lab result, you can blame it on the tests results and the lab.

Most patients are subsidized patients anyway, and unless you are a private patient, the hospital actually loses money on lab tests. The government provides a fixed subvention for subsidized patients and if you use it up on unnecessary lab tests and go into deficit, the hospital has to pick up the tab.

You can only earn money on the private patients. So if the intention is to earn money on lab tests, what will happen is that they overservice the private patients and deny subsidized patients even necessary tests. I don't think that is the case because doctors are afraid of being sued, and it is more likely that they would overservice patients just so that they cannot be blamed if something goes wrong. Therefore I really think the reason for unnecessary tests is because doctors don't want to be sued...they want to protect their backsides. I know that is true because I have done it myself Embarassed

By the way, hospitals earn more money on operations rather than lab tests. That is why they are outsourcing X-rays and other tests to India...to cut their overheads and increase their margins. If we can earn so much from diagnostic tests, why are we so keen to send them away? No, the fact is that we lose money from these tests.

If doctors want to please their administrators, they will do more cosmetic surgery, put in breast implants and do laser keratoplasty (for shortsightedness), not order more lab tests.

BTW, I didn't realize that polyclinics charge more for lab tests than TTSH.....most polyclinic lab services are outsourced to private labs. If TTSH labs can do it motre cheaply, I cannot understand why they continue to outsource the service either...

oxford mushroom SG

No, I do not think the opinion expressed is fair. Patients are free to ask for a prescription from the polyclinics if they think they can get medication more cheaply from Guardian pharmacy and the like. I do not think polyclinics are a money-making venture but I do agree that polyclinic managers are pressured to remain in the black despite the fact they are serving the poorer sector of the population.

The biggest chunk of overheads in polyclinics is manpower. To cut polyclinic prices, guess we'll have to bring in more foreign doctors and nurses instead of employing locals then.

claudetnt SG

oxford mushroom:

i never said you can get free medication under the NHS all i said was some drugs are cheaper in UK than in our polyclinics.

my friend (who is suffering from Asthma) gets his daughter, who is a flight hostess, to buy his supply of inhalers from the UK and he tells me that its about 15 to 20% cheaper than buying from the polyclinics.

Another friend is getting his high blood pressure pills from the Uk and its also cheaper than in our polyclinics.

our people in the MOH needs to open their books to the public.

claudetnt SG

Mate,

I think you are drifting away from the discussion we are talking about polyclinics and public hospitals.

Most of these patients are subsidized patients and they do not enough money even to pay the bills let alone sue the doctors?

I do not think there was even a certain instance where a patient from a polyclinic had sued a doctor in Singapore!

I do not for how much longer, I am sure one of KBW top priority will definitely be to adjust upwards the prices of not only the drugs but also the lab tests so that all these charges will be more expensive in government hospitals very soon!

oxford mushroom SG

If you do have facts and figures, present it to your MP or write to Straits Times Forum page.

Prescription drugs in the UK are capped at a low price because the government subsidizes the drugs. If you expect the Singapore government to subsidize the cost of medications, then you must be prepared to pay higher taxes.

Are you?

oxford mushroom SG

my friend (who is suffering from Asthma) gets his daughter, who is a flight hostess, to buy his supply of inhalers from the UK and he tells me that its about 15 to 20% cheaper than buying from the polyclinics

I am very surprised your friend can do that in the UK. As a registered medical practitioner with the GMC here in the UK, I am not aware that our pharmacists will allow a third person to buy prescription drugs just like this. They have a duty of care to the patient for whom the drug has been prescribed. If the person purchasing the medication cannot show evidence that he is the carer for the patient, the pharmacist is not supposed to sell the medication.

Anyway, I checked with one pharmacy here, cost of 3 ventolin inhalers for a private patient is £22.49 + 17.5% VAT. Is it cheaper than the price at a polyclinic?

Atobe SG

What is the purpose of certain common medicinal items being classified as controlled item to be dispensed with an authorised prescription written by a qualified medical practitioner ?

Will such practise not increase the cost of medicine being dispensed ?

Does it not lead to higher costs when patients have to pay for a Doctor to write up a prescription, and then a Pharmacist to dispense it ?

In some countries, some non-potent medicinal products are often and normally recommended and / or prescribed by qualified pharmacist - without the need of doctors or medical practitioners.

claudetnt SG

oxford mushroom:

"if you do have facts and figures, present it to your MP or write to Straits Times Forum page.

Prescription drugs in the UK are capped at a low price because the government subsidizes the drugs. If you expect the Singapore government to subsidize the cost of medications, then you must be prepared to pay higher taxes.

Are you? "

i thought i had done better by writing to the minister himself but do you know some of our ministers do not respond nor correspond with simple folks like us!

Paying higher taxes is not the solution. Malaysians and Thais do not pay more than taxes than us but the medicines sold there are relatively much cheaper than ours.

charlize SG

Mr Tan Cheng Bok already brought it up to the health minister in Parliament and the solution provided was to consider increasing the lower cost to match the higher cost.

So what else can the commoners do if even the MPs cannot help?

And worse still, prices might increase too because of this situation. Laughing

zheshi SG

Last time i thought seeing doctor in polyclinic is cheap, but heh. Not consider cheap at all lo. Can come up to 15plus liao. My house there private doctor only charge 18 to 20..

claudetnt SG

charlize:

very good point. Yes, you're absolutely right.

The next thing we should do is not vote for him at the coming election. Chances are he will be no longer be with LKY and that is good news more chances for him to be kicked out!

oxford mushroom SG

Because certain drugs have adverse effects and potentially dangerous interactions with other drugs...the pharmacist would not know of the patient's medical conditions. For example, beta-blockers are often prescribed for hypertension and they are good for some patients. But if a patient who also has asthma can just purchase it from the pharmacist based on a recommendation by a friend who has hypertension, he could die from an asthmatic attack. Another reason is to prevent drug resistance from improper use, particularly relating to antibiotics. Some dugs such as retinoic acid analogues are very effective for acne, which some might consider a minor ailment. But the drug can cause horrendous deformities in babies if the patient happens to get pregnant.

'Non-potent' medication such as lozenges, antiseptic cream and the like are already available over the counter.

oxford mushroom SG

Computers are also cheaper in Malaysia and Thailand. The lower labour and rental costs translate into lower manufacturing and retail costs. Also, drug companies are willing to lower their prices for certain countries because the population is poorer and they would not be able to afford the higher prices charged in first world countries like Singapore. That is why there are strict contracts preventing parallel imports of many drugs.

For certain drugs, eg. anti-retrovirals for HIV, Thailand has imposed compulsory local licensing regulations that allow their local drug companies to ignore patents and manufacture these drugs for local consumption. Obviously this will not attract many drug companies to set up shop there. compared to Singapore, for example.

If you compare with the UK though, are you sure that our polyclinics are more expensive? As I have checked, 3 Ventolin inhalers for asthma costs about S$75 in the UK for private (non-NHS) patients. Do our polyclinics charge that much?

claudetnt SG

oxford mushroom;

"---3 Ventolin inhalers for asthma costs about S$75 in the UK for private (non-NHS) patients. Do our polyclinics charge that much?---"

Since you mentioned the last time, tried to get a price over the telephone but the good people in the polyclinic are reluctant to quote over the tele, have to make a trip to the poly to find out, will do and revert.

claudetnt SG

Oxford mushroom;

Why do you think KBW / MOH rejected, in 2005, the offer to jointly have public-private tenders to buy drugs in bulk which could have reduced the cost overhead of the private health-care sector, allowing the latter to become more competitive to the point of potentially offering more cost-effective health services than that in polyclinics?

oxford mushroom SG

I am sure doctors in private practice will welcome a joint tender. The problem is that the pharmaceutical industry is willing to do a special deal with the public sector because otherwise they will not be able to get their drugs into the market in the first place. So they sell their drugs at a lower price to MOH, earn less from public hospitals and get their profits from the private sector. With public-private joint tender, the drug companies will not give MOH such a good deal. In the end, patients in public hospitals will lose out

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