Medicine prices: A horror story
Medicine prices: A horror story
The Jakarta Post's headline story about the prices of medicine
(Sept. 15, 1996) quoted me as saying: "They are criminals," with
the "they" implying "government employees, pharmacy owners and
medical practitioners" without further characterization. This is
a statement that should be regarded in the context of the
conversation, and should be addressed to the act instead of
"they".
Although medicine prices in Indonesia are not the cheapest in
the world, for old generic drugs the cost is quite low. But for
many pivotal drugs, as can be seen in the table provided in the
same Sunday issue, the prices are exorbitantly high.
In discussing why it is so, I talked about government health
and drug policies, drug pricing policies, high profit margins in
the drug chain and the extent of irrational prescribing. I also
questioned the inaccessibility (to prescribers) of an unbiased
drug information source, the untouchable industry-medical
complex, pharmacy stores that overcharge for prescriptions, and
the pharmaceutical industry which offers kickbacks to prescribers
in return for prescribing their drugs, and other immoral
marketing practices.
Clinical laboratories are doing the same, by the way. I also
discussed the fact that many young doctors in Indonesia do not
earn enough to live decently. There are doctors who run from one
hospital to other hospitals to increase their income.
The lack of health insurance for most people and out of pocket
payment for health services are problems that can result in
unnecessary suffering and even death. The unethical attitude of
health services exists merely to increase income. Other problems
include spiraling prescription costs and the increased side
effects that occur when multiple drugs are being used.
If one looks at the problem and the complexities that cause
these to occur, can one then wait patiently until some wise guy
has the guts to regulate all this? Can we trust our health
system? If we do nothing to improve the situation now, it may
well be too late for a change because wrong concepts and values
are becoming accepted as normal.
DR. IWAN DARMANSJAH
Jakarta