The Ministry of Health (MOH) has clarified its move to temporarily suspend Patient Access Schemes (PAScs) that provided free high-cost medications to patients in need.

In a Facebook press release dated 16 August, MOH Director-General Datuk Dr Noor Hisham Abdullah stated that the suspension applied specifically to those PAScs which involved the ‘bonusing’ of free medication packs in conjunction with purchases of other medicines from pharmaceutical companies by MOH facilities.

“The Ministry wishes to emphasize that other existing schemes currently in progress are being continued as per normal in government health facilities,” said Noor Hisham. “There is also no impediment from the Ministry for any distribution of free packs under charity or compassionate use to patients with caveats that do not involve purchases by the Ministry.

Noor Hisham added that the suspension was temporary and pending review of PAScs by the National Audit Department, and that the matter had been explained in full to all relevant stakeholders.

“It is feared that the provisions of free packs in this case may be against ethical guidelines and raise issues of integrity, given that the provisions are not described in detail in the purchase records between pharmaceutical companies and MOH facilities,” said Noor Hisham. “This matter needs to be examined together with the responsible parties.”

Initial news of the suspension was originally broken by online news portals on the morning of 16 August, based on letters sent to pharmaceutical companies after a 9 August meeting between the Pharmaceutical Services Division (PSD) and the Director-General. The letters stated that “[the PSD] has been requested to obtain views from the National Audit Department on the issue of civil servants’ integrity in the acceptance of free packs upon the procurement of drugs.”

This led to a brief furore over what appeared to be a blanket suspension of all free medicines provided under PAScs, with representatives from the Galen Centre of Health and Social Policy voicing concerns that such a move would impact many patients currently dependent on those medications.

An intent to set standards

In the same statement, Noor Hisham said that a set of guidelines had been prepared in the MOH on 1 June this year with the intent of explaining the process of application, evaluation and certification of PAScs in MOH facilities.

“PAScs are offered by pharmaceutical companies to the Ministry to improve medication access for patients, especially for expensive innovative medicines,” said Noor Hisham. “The Garis Panduan Permohonan Melaksanakan Patient Access Scheme (PASc) aimed to standardize the application process to be transparent, and to ensure PASc proposals by pharmaceutical companies met with established conditions.”

Further applications for PAScs are currently on hold as the National Audit Department conducts its review. As of the current publication date, the Guidelines which were previously available for viewing on the PSD’s online portal have been taken down.

“The MOH remains committed in ensuring patients obtain access to medicines and that it is carried out transparently for the benefit of Malaysian citizens,” said Noor Hisham.