Asia Medical eNewsletter
October 2004
Singapore : New Medical Service Package Offers Subsidies for Cardiac Treatment/Devices
In an effort to ensure that Singaporeans receive quality healthcare at reasonable prices, Singapore’s Ministry of Health introduced the Medical Service Package (MSP) on July 2, 2004. The MSP, which took effect in all public institutions on July 5, 2004, will allow some patients to receive subsidies for medical care. The program will start by providing subsidies for a number of cardiac devices, including cardiac stents, defibrillators and pacemakers. If this program is successful, the Ministry of Health will consider expanding the program to other medical specialties.
The MSP will provide subsidies for patients in Ward/Class B2 and C (which have six or more beds per room and do not have air conditioning). Patients in Wards A1, A2 and B1 (which have four or fewer beds per room as well as air conditioning) are not eligible to receive subsidies. The MSP will cover cardiac medical devices, procedures, investigations and even some cardiac drugs. These services are grouped into three categories and are based on medical necessity. (1) The Basic service includes standard healthcare services, where the indications are not controversial. (2) The Extended service refers to newer or more advanced medical services, some of which are controversial. Extended service is only required in special circumstances for certain patients; or in a case where the indications are still evolving. (3) Excluded service consists of non-essential medical services, like cosmetic surgery or experimental treatments.
The main goal of the MSP is to ensure that patients are not “over-serviced” by healthcare providers. Therefore, the program has set up a system of peer review to make sure that patients receive the correct treatment, and are not subject to any unnecessary tests or treatment. However, the medical team in charge of treating a patient will make its treatment decision based on the patient’s needs, not the patient’s ability to pay. In the case where patients are still unable to pay their medical bills despite the subsidies, they will be referred to a medical social worker.
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Japan : MHLW Standardizes Generic Drug Names
Japan ’s Ministry of Health, Labor and Welfare (MHLW) recently issued a regulation to standardize the names of generic drugs. In the past, some generic drugs were given similar names, often causing confusion and even dispensing errors by pharmacists, doctors and hospitals. The new regulation aims to reduce these errors by requiring specific labeling information on the packaging or the drug itself.
Previously, pharmaceutical companies in Japan were free to name generic drugs after brand patents expired, and the barrage of similar names resulted in numerous administering mistakes. But with the new regulation in effect, the Ministry expects that within the next ten years, the majority of drugs used at national medical institutions will have standard brand or product names, rather than a large number of confusing names.
Under the new regulation, all generic drugs must display the name(s) of their manufacturing company on the container or packaging. In addition, the list of active ingredients and their quantities must either be inscribed on the individual tablets or displayed on the packaging. Japanese officials believe that these requirements will encourage the use of generic drugs, as patients and doctors will be able to see that generic drugs contain the same active ingredients as name brand drugs, but cost only a fraction of the price.
The development of Japan’s generic drug market still lags behind that of the U.S. and Europe, partially due to the overall notion that generic drugs are inferior and to the high level of “brand consciousness” in Japan. Moreover, some Japanese doctors are unaware of generic drug names, and under current Japanese pharmaceutical laws, pharmacists can administer a generic drug brand only if a doctor prescribes it. Furthermore, drug wholesalers in Japan often have close ties to patented drug makers and therefore, do not handle many generic drugs. Likewise, low drug prices often deter wholesalers to offer any discounts, since there may be little profit from generic drugs.
However, as the government is facing escalating medical costs, the number of cost-conscious patients is also on the rise. Patients are beginning to take notice of their medical bills, and a few hospitals have already begun issuing only generic drug prescriptions. Patients and hospitals can save up to 80 percent when opting for generic drugs rather their brand-name counterparts.
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Prescription Required to Purchase Antibiotics in China: An Update
In a move to address antibiotic abuse in China, the Ministry of Health and the State Food and Drug Administration (SDFA) issued a new regulation, effective July 1, 2004, limiting the purchase of antibiotics to patients who have received a doctor’s prescription. Previously, no prescription was needed to purchase antibiotics in China. Moreover, there was no limit on the quantity of antibiotics that could be purchased by an individual. The SFDA’s new regulation intends to reduce the misuse of antibiotics and to help educate the public about the consequences of excessive antibiotic use.
Major drugstores in China carry up to 200 different types of antibiotics, and prior to July 1, 2004, these antibiotics were readily accessible to all people. Additionally, due to the high costs of healthcare, many citizens relied on self-diagnosis for years and tended to purchase antibiotics for all minor illnesses, including the common cold. Thus, antibiotic abuse is purportedly responsible for half of the country’s cases of deafness and almost 2.5 million people are hospitalized every year for adverse reactions to antibiotics. The SFDA hopes the new regulation will curb antibiotic abuse in China by reducing the accessibility of antibiotics.
Nevertheless, there are some concerns about the new regulation. Some people believe that drugstores may ally with hospitals or hire hospital doctors to write prescriptions for antibiotics, helping to sustain drugstores’ high profits from antibiotic sales. Fake prescriptions could also become an issue, as people try to buy antibiotics without seeing a doctor. Hospitals have prepared for the new regulation by designating specific codes for antibiotics, which will be inscribed on prescription pads and electronic prescriptions at major hospitals, allowing doctors and pharmacists to verify the authenticity of prescriptions.
Conversely, the restrictions on antibiotic use may pave the way for makers of traditional Chinese medicine (TCM). TCM used to treat the common cold, inflammation and allergies is not labeled as an antibiotic and may be a cheaper alternative to Western antibiotics. A TCM factory has already been established in Guangzhou to conduct further research on “TCM antibiotics.”
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Taiwan : New Investment Opportunities for Foreign Biotech Companies
In order to attract more foreign companies to collaborate with domestic companies and develop advanced technologies in Taiwan, the Taiwanese government has launched several programs to lure foreign investors into the country’s biotechnology sector. Additionally, the Taiwanese government also hopes to expand the sector by offering better biotechnology products and healthcare services for the rising elderly population. This will be done through the establishment of a new biotechnology model for Taiwan’s healthcare system.
To attract major investors, the Taiwanese government is offering incentives for those who invest in Taiwan’s biotechnology sector. First, investors can receive tax deductions, and possibly full tax exemptions, depending on the particular biotechnology field in which the company invests. Second, investors are also eligible to receive low interest loans and rent discount plans. Finally, the Taiwanese government provides research and development assistance to support further technology development in Taiwan.
The Ministry of Economic Affairs (MOEA) has set up a number of biotechnology investment projects, with an annual goal investment of NT$20 billion (US$583.5 million). The Development Center for Biotechnology (DCB) is responsible for several of these projects, including the BioFronts Program. This program aims to bring domestic and international biotechnology companies together to set up joint ventures in Taiwan.
Currently, the proportion of people 65 years and older in Taiwan is about 10%. However, by the year 2030, the number will expand to about 15%, and by 2050, the proportion of people over 65 years will grow to nearly 30%. To provide for Taiwan’s aging population, the Industrial Technology Research Institute (ITRI) plans to create various programs in Taiwan’s healthcare department, for the specific purpose of improving the biotechnology sector. Integrating medical services, portable medical devices, and the storage and transmission of medical information are the main focuses of ITRI’s new programs. Additionally, long-distance healthcare systems, a more convenient and effective way of providing medical treatment for the elderly, will be a vital part of the new biotechnology model.
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