'Self-dispending' policy welcomed by doctors' body

JAKARTA (JP): The Indonesian Doctors Association (IDI) welcomed yesterday the government's "self-dispensing" policy which will see general practitioners directly provide medicines to their patients.

The association lauded the Ministry of Health's June 9 decision as "a political decision which was taken for the sake of people's welfare".

"There are two internationally known ways of handing drugs to patients. One is through prescriptions, the other is self- dispensing by doctors.

"To date there is no data that shows which is superior, either ethically or from the service quality point of view," it said in a statement.

The statement, signed by association chairman Dr. Merdias Almatsier and secretary-general Dr. Hasbulah Thabrany, said the association urged members to uphold their professional integrity in supporting the government's policy.

"By so doing, it is hoped that we can answer worries and concerns expressed by many parties that the policy will lead to irrational medical therapy, more expensive health expenses and the crippling of the drug distribution system if the policy is implemented," its statement, distributed during a small seminar on health development policy reform here, said.

One reason why the association welcomes the decision is that it may help alleviate the costs currently passed on to patients.

"The policy gives practicing doctors the opportunity to dispense generic drugs that fit the socioeconomic background of their patients," the announcement said.

However an association executive, Dr. M. Ahmad Djojosugito, warned that the measure, aimed at cutting prices of generic drugs by an average of 30 percent, could fail should there be "badly behaved doctors".

"The downside is that no control and reports are required ... Some naughty doctors could just keep charging their patients the same old prices (which are supposed to be 30 percent lower)," Ahmad, who is also director of the state Cipto Mangunkusumo General Hospital, told The Jakarta Post.

The association pointed out that the protracted distribution chain of medicines contributed to the rising prices of generic drugs.

"This self-dispensing measure will cut a part of the distribution chain and thus the prices of drugs significantly," the association said.

Not surprisingly, grumbles came from pharmaceutical manufacturers.

Ahaditomo, of the Association of Indonesian Pharmaceutical Manufacturers, argued that the exact opposite would occur as the self-dispensing policy would simply "extend distribution networks".

What was more essential, he said, was for industries to make production of generic medicines more efficient and thereby facilitate the lowering of prices.

"More efficient production will automatically lead to lower pricing," Ahaditomo, who is marketing director of PT Meiji Indonesian Pharmaceutical Industries, told reporters.

Since the monetary crisis hit the country last year, prices of patented drugs have reportedly increased up to 300 percent.

Generic drug prices, relatively stable since l993, have also soared by as much as 150 percent recently, causing many public complaints about their affordability.

Generic drugs account for about 80 percent of prescribed medications.

Up to 90 percent of the raw materials used to manufacture the country's medications are imported.

Yesterday, IDI also urged the government to eliminate various fees, such as value-added tax, warehousing costs and illegal levies, imposed on pharmaceutical manufacturers importing raw materials for medicines.

They argued that such raw materials should be considered "basic essentials". (aan)